title: Epidermal grafting versus split-thickness skin grafting for wound healing (EPIGRAAFT): study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal donor site morbidity and is relatively pain-free, allowing autologous skin grafting in an outpatient setting. We plan to compare EG to SSG and to further investigate the cellular mechanism by which each technique achieves wound healing.
  
  
  METHODS
  EPIGRAAFT is a multicentre, randomised, controlled trial that compares the efficacy and wound-healing mechanism of EG with SSG for wound healing. The primary outcome measures are the proportion of wounds healed in 6 weeks and the donor site healing time. The secondary outcome measures include the mean time for complete wound healing, pain score, patient satisfaction, health care utilisation, cost analysis, and incidence of adverse events.
  
  
  CONCLUSIONS
  This study is expected to define the efficacy of EG and promote further understanding of the mechanism of wound healing by EG compared to SSG. The results of this study can be used to inform the current best practise for wound care.
  
  
  BACKGROUND
  Clinicaltrials.gov identifier, NCT02535481 . Registered on 11 August 2015.
authors.affiliation: Division of Surgery & Interventional Science, University College London, London, UK.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: Muholan
authors.initials: M
authors.lastname: Kanapathy
authors.affiliation: Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hachach-Haram
authors.affiliation: Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bystrzonowski
authors.affiliation: Cardiff University, Wound Healing Research Unit, School of Medicine, Heath Park, Cardiff, UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Harding
authors.affiliation: Division of Surgery & Interventional Science, University College London, London, UK. a.mosahebi@ucl.ac.uk.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK. a.mosahebi@ucl.ac.uk.
authors.forename: Afshin
authors.initials: A
authors.lastname: Mosahebi
authors.affiliation: Division of Surgery & Interventional Science, University College London, London, UK.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: Toby
authors.initials: T
authors.lastname: Richards
mesh_terms: D001706:Biopsy; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D004817:Epidermis / Q000473:pathology / Q000637:transplantation*; D017048:Health Care Costs; D006801:Humans; D008131:London; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012107:Research Design; D016038:Skin Transplantation / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D000072836:Surgical Wound / Q000473:pathology*; D013997:Time Factors; D060053:Transplant Donor Site; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014852:Wales; D058106:Wound Closure Techniques / Q000009:adverse effects / Q000191:economics; D014945:Wound Healing
keywords: CelluTome; Epidermal graft; Split-thickness skin graft; Wound healing