title: Effectiveness of collagen/oxidised regenerated cellulose/silver-containing composite wound dressing for the treatment of medium-depth split-thickness skin graft donor site wounds in multi-morbid patients: a prospective, non-comparative, single-centre study.
abstract: Split-thickness skin grafting (STSG) is a widely used method in reconstructive surgery, but donor site wounds (DSWs) are often slow healing and painful. This prospective study evaluated the performance of a composite wound dressing containing collagen/oxidised regenerated cellulose in the treatment of medium-depth (0·4 mm) DSWs in 25 multi-morbid patients with chronic leg ulcers requiring STSG. The range of patients' ages was 44-84 years (mean 71·6 years) with DSW sizes ranging between 12 and 162 cm2(mean 78 cm2). Comorbidities included anticoagulation therapy (15 patients), anaemia (11 patients), diabetes (6 patients) and methicillin-resistant Staphylococcus aureus (MRSA) ulcer colonisation (6 patients). The first dressing change was performed after 10 days. Complete reepithelialisation was observed between the 10th and 34th day (mean 17·2, median 14 days). Postoperative medium to strong bleeding occurred in only five patients (four with anticoagulation). Wound pain levels one day after harvesting were only moderate (range 0-1·5, mean 0·5, median 0·5 on a six-item scale). No wound infection was observed during the first dressing. The composite dressing used allowed for the fast healing of medium-depth DSWs with minimal or no postoperative pain and bleeding in older multi-morbid patients under anticoagulation treatment.
authors.affiliation: Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Konstantinow
authors.affiliation: Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
authors.forename: Tatjana V
authors.initials: TV
authors.lastname: Fischer
authors.affiliation: Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D005260:Female; D020773:Headache Disorders / Q000628:therapy*; D006801:Humans; D007871:Leg Ulcer / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012834:Silver / Q000627:therapeutic use; D016038:Skin Transplantation / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology*
chemical_list: D002483:Cellulose, Oxidized; D012834:Silver; D003094:Collagen
keywords: Anticoagulants; Bleeding; Cellulose/collagen dressing; Comorbidities; Donor site wounds