title: Repair of the donor areas defects after split-thickness skin grafts utilizing an advanced epithelialization dressing.
abstract: BACKGROUND
  The management of surgical wounds of the donor areas for split-thickness skin grafts might be difficult in terms of pain, risk of infection, and delayed healing.
  
  
  METHODS
  In the period from September 2011 to June 2012, 12 patients affected by large ulcerated basal cell carcinoma (BCC) of the lower legs, 2 patients affected by squamous cell carcinoma (SCC), and 1 patient presenting malignant melanoma located on the scalp, with split-thickness skin grafts were treated. In the 12 BCC patients, the donor site areas were situated on the anterior or lateral site of the contralateral thigh and in 3 other patients on the forearms. Immediately after dermatome skin removal of 0.3 mm layer of epidermis, the donor sites were treated by applying an advanced epithelialization dressing consisting of pure cellulose film in all patients. The wound surfaces were covered by the cellulose dressing with 1 cm of excess. Bleeding was controlled with slight compression with sterile gauzes before the medication was applied. Multiple small cuts of the cellulose dressing, with a No. 11 surgical blade were made, in order to avoid hematoma formation or fluid accumulation. A mild compression bandage was used in all patients. The patients were visited after 7, 14, and 21 days. The bandage was removed after 1 week and the medical device was left at the site for other 7 days.
  
  
  RESULTS
  After 2 weeks, the medical device was partially detached on the underlying areas showing almost completely reepithelialization. Almost no pain was referred by the patients. In the authors' experience, this medical device markedly reduces the level of pain especially at the time of dressing application, after the surgical procedure, and during the healing process. No infections were observed. The healing process was fast and produced good aesthetic results.
  
  
  CONCLUSIONS
  The use of Cuticell® Epigraft BSN medical device simplifies the management and healing of the donor areas for split-thickness skin grafts.
authors.affiliation: Department of Internal Medicine, Division of Dermatology, Geriatric Diseases and Nephrology, University of Bologna , Bologna , Italy.
authors.forename: Pier Alessandro
authors.initials: PA
authors.lastname: Fanti
authors.forename: Emi
authors.initials: E
authors.lastname: Dika
authors.forename: Sabina
authors.initials: S
authors.lastname: Vaccari
authors.forename: Cosimo
authors.initials: C
authors.lastname: Misciali
authors.forename: Alma
authors.initials: A
authors.lastname: Ismaili
authors.forename: Alessia
authors.initials: A
authors.lastname: Barisani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002482:Cellulose / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D062326:Re-Epithelialization; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D060053:Transplant Donor Site; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*
chemical_list: D003879:Dermatologic Agents; D002482:Cellulose