Clinical trial comparing 3 different wound dressings for the management of partial-thickness skin graft donor sites.
OBJECTIVE
A review of the literature reveals a lack of consensus regarding local management of skin graft donor sites. This study was undertaken to determine the effects of 3 different dressings on healing of donor sites and patient discomfort related to donor sites.


METHODS
This study is a comparison cohort study.


METHODS
We recruited 34 burn patients scheduled for partial-thickness skin grafts; their mean age was 36 ± 18 years (mean ± SD, range 20 to 54 years), and 63% were male. All subjects were managed at Burn Unity Care, located in Sao Paulo, Brazil.


METHODS
Subjects were randomly allocated to 1 of 3 groups: (1) a study group (group A) whose donor sites were dressed with a bovine collagen calcium-alginate dressing covered with transparent polyurethane film; (2) a second intervention group (group B), whose donor sites were dressed only with transparent polyurethane film dressing; and (3) a control group whose donor sites were dressed with rayon soaked in 0.9% saline (group C). Two independent observers assessed donor site wounds for epithelialization, scabbing, quantity and characteristics of exudate, and complications. Pain was measured using the visual analog scale, the brief pain inventory, and Index of Pain Management.


RESULTS
Subjects managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film (group A) achieved the greatest epithelialization (6.3 vs 8.2 for thin film dressing only P < .02 and 6.3 vs 11.7 days for control group P < .01). Patients managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film also reported less pain that subjects allocated to the control (group C) or thin film only group (group B), (P < .05). Ninety percent of subjects allocated to the calcium alginate covered with thin film dressing reported mild pain intensity on the Visual Analog Scale, 85% of did not report pain localized to the donor site on the brief pain inventory, and scores on the Index of Pain Management ranged from 23 to 11.


CONCLUSIONS
Study findings suggest that use of a collagen calcium-alginate dressing with a transparent film covering reduces the time for complete epithelialization and may reduce pain related to skin graft donor sites.
Doctor in Health Sciences, Faculty of Medicine, Cell Culture and Wound Healing Research Laboratory, Division of Plastic Surgery, University of São Paulo, Brazil. vivianefcarvalho@usp.br
Viviane
V
Fernandes de Carvalho
André Oliveira
AO
Paggiaro
Cesar
C
Isaac
Júlio
J
Gringlas
Marcus Castro
MC
Ferreira
D000328:Adult; D000464:Alginates / Q000008:administration & dosage*; D001458:Bandages; D002056:Burns / Q000601:surgery; D003094:Collagen / Q000008:administration & dosage*; D005260:Female; D020723:Glucuronic Acid / Q000008:administration & dosage; D006603:Hexuronic Acids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D016038:Skin Transplantation; D060053:Transplant Donor Site; D014945:Wound Healing
D000464:Alginates; D006603:Hexuronic Acids; D020723:Glucuronic Acid; D003094:Collagen