Occlusive drainage system for split-thickness skin graft: A prospective randomized controlled trial.
BACKGROUND
Split-thickness skin grafts are widely used in reconstruction of large area defects. Conventional postoperative recipient site care includes saline-moistened gauze with a protective layer of petroleum gauze and splints for immobilization. This method causes pain while changing the dressing. We designed a better occlusive drainage system for split-thickness skin grafts. We compared the treatment effect and subjective evaluation of our occlusive drainage system with that of the conventional method for coverage of split-thickness skin grafts.


METHODS
A randomized controlled trial was carried out in patients who received split-thickness skin grafts. Patients aged 24-76 years were randomly assigned to the occlusive drainage system or the conventional indirect wet dressing method. The status of graft take, pain, and subjective evaluations were compared.


RESULTS
Twenty-eight participants were enrolled, with 14 in each group. The percentage of graft take was no difference between the 2 groups. No wound infection developed. Patients in the occlusive drainage system group experienced less pain and greater satisfaction. All patients followed up for at least 3 months, and no hypertrophic scar formation was noted.


CONCLUSIONS
Comparing with the indirect wet dressing method, this new method is practical for covering split-thickness skin grafts, causes less pain, and provides a better experience for patients.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Sara Fu-Yin
SF
Hsiao
Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hsu
H
Ma
Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
Yu-Hei
YH
Wang
Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: wangts@vghtpe.gov.tw.
Tien-Hsiang
TH
Wang
D000328:Adult; D000368:Aged; D002056:Burns / Q000601:surgery / Q000628:therapy*; D017439:Cicatrix, Hypertrophic / Q000601:surgery; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D010146:Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016038:Skin Transplantation / Q000379:methods; D014945:Wound Healing; D055815:Young Adult
Negative pressure wound therapy; Occlusive drainage system; Split-thickness skin graft; Wound care; Wound dressing