Silver Sulfadiazine–Impregnated Hydrocolloid Dressing Is Beneficial in Split-Thickness Skin-Graft Donor Wound Healing in a Small Randomized Controlled Study

2016 ◽  
Vol 15 (4) ◽  
pp. 338-343 ◽  
Author(s):  
Sadanori Akita ◽  
Hiroshi Yoshimoto ◽  
Katsuya Tanaka ◽  
Masao Oishi ◽  
Chikako Senju ◽  
...  
Keyword(s):  
Wound Healing ◽  
Donor Site ◽  
Corneal Thickness ◽  
Silver Sulfadiazine ◽  
Controlled Study ◽  
Split Thickness Skin Graft ◽  
Blue Color ◽  
Color Analysis ◽  
Intact Skin ◽  
Hydrocolloid Dressing

Donor-site wound healing was tested with a silver sulfadiazine (SSD)-impregnated hydrocolloid dressing and hydrocolloid dressing applied manually by a physician on site. A total of 14 patients, 5 woman and 9 men (23-89 years old, average = 61.6 ± 18.70 years), were enrolled in this prospective controlled study. The degree of bleeding was significantly less with the SSD-impregnated than with the hydrocolloid dressing (P < .01). In the moisture meter analysis, the values of the effective contact coefficient and corneal thickness were significantly smaller with the SSD-impregnated dressing (P < .05). In the color analysis, the clarity was significantly lower with the hydrocolloid dressing after 3 months than that of intact neighboring skin (P < .01). Regarding red-green color, SSD-impregnated and hydrocolloid values were significantly greater than the intact skin value immediately after and at 3 months, and the hydrocolloid value was significantly greater than intact at 6 months (P < .01 immediately; P < .01 at 3 months and intact at 6 months) in redness. Regarding yellow-blue color, the hydrocolloid value was significantly lower than the intact skin value at 3 months (P < .05 and intact) in yellow. The extensibility was significantly lower with the hydrocolloid dressing than in intact skin immediately (P < .01), and viscoelasticity was significantly lower with the hydrocolloid dressing than in intact skin immediately and after 3 and 6 months (P < .01 immediately and at 6 months and P < .05 at 3 months). The SSD-impregnated hydrocolloid dressing led to superior wound healing, decreased the degree of bleeding, and demonstrated better corneal barrier function, clarity, color matching, and viscoelasticity in split-thickness donors.

scholarly journals CICAFAST: comparison of a biological dressing composed of fetal fibroblasts and keratinocytes on a split-thickness skin graft donor site versus a traditional dressing: a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexandra Poinas ◽  
Pierre Perrot ◽  
Judith Lorant ◽  
Olivier Nerrière ◽  
Jean-Michel Nguyen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Skin Grafts ◽  
Thickness Skin ◽  
Fetal Fibroblasts ◽  
Biological Dressing ◽  
Graft Donor

Abstract Background Wound repair is one of the most complex biological processes of human life. Allogeneic cell-based engineered skin substitutes provide off-the-shelf temporary wound coverage and act as biologically active dressings, releasing growth factors, cytokines and extracellular matrix components essential for proper wound healing. However, they are susceptible to immune rejection and this is their major weakness. Thanks to their low immunogenicity and high effectiveness in regeneration, fetal skin cells represent an attractive alternative to the commonly used autologous and allogeneic skin grafts. Methods/design We developed a new dressing comprising a collagen matrix seeded with a specific ratio of active fetal fibroblasts and keratinocytes. These produce a variety of healing growth factors and cytokines which will increase the speed of wound healing and induce an immunotolerant state, with a slight inflammatory reaction and a reduction in pain. The objective of this study is to demonstrate that the use of this biological dressing for wound healing at the split-thickness skin graft (STSG) donor site, reduces the time to healing, decreases other co-morbidities, such as pain, and improves the appearance of the scar. This investigation will be conducted as part of a randomized study comparing our new biological dressing with a conventional treatment in a single patient, thus avoiding the factors that may influence the healing of a graft donor site. Discussion This clinical trial should enable the development of a new strategy for STSG donor-wound healing based on a regenerative dressing. The pain experienced in the first few days of STSG healing is well known due to the exposure of sensory nerve endings. Reducing this pain will also reduce analgesic drug intake and the duration of sick leave. Our biological dressing will meet the essential need of surgeons to “re-crop” from existing donor sites, e.g., for thermal-burn patients. By accelerating healing, improving the appearance of the scar and reducing pain, we hope to improve the conditions of treatment for skin grafts. Trial registration ClinicalTrials.gov, ID: NCT03334656. Registered on 7 November 2017.

scholarly journals Application of Honey and Transparent Dressing to Split Thickness Skin Graft Donor Site and Its Effect on Epithelialization Rate

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Teuku A. ◽  
Nandita Melati P. ◽  
Gentur Sudjatmiko ◽  
Asrofi S. ◽  
Ishandono D.
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Parallel Design ◽  
Thickness Skin ◽  
Graft Donor ◽  
The Mean ◽  
Clinical Photograph

Background: Split thickness skin graft (STSG) is one of the modalities used to close a defect. The donor site can be healed secondarily with tulle grass and moist gauze after 14 days and with transparent dressing will take about 10-13 days. Recently the wound healing by using honey application has been used. Whether or not using honey application with transparent dressing will hasten the epithelialization rate of the STSG donor site is now in question. Method: This research is an open, non-randomized clinical trial with a parallel design and intervention using honey application with transparent dressing. A total of 19 patients (7 female and 8 male) were included in this study. The reapplication of honey was done every two days. The patients was followed up every day, with clinical photograph taken and complaints such as pain, odor and infection noted. Results: The mean epithelialization rate of the donor site treated with honey and transparent dressing was 9,74 (+0,24) days compared to 10,79 (+1,23) days in the transparent-dressing-only group (p=0,00). Conclusion: The application of honey with transparent dressing to cover for STSG donor site led to a faster epithelialization rate, less odor and less pain. Commercial honey was used, and readily available.

scholarly journals Effect of Subcutaneous Adrenaline/Saline/Lidocaine Injection on Split-Thickness Skin Graft Donor Site Wound Healing

2021 ◽  
Vol 64 (1) ◽  
pp. 107-112
Author(s):  
Kohei Fukuoka ◽  
Shunjiro Yagi ◽  
Yoshiko Suyama ◽  
Wataru Kaida ◽  
Maki Morita ◽  
...  
Keyword(s):  
Wound Healing ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Lidocaine Injection ◽  
Graft Donor

scholarly journals Clinical Efficacy Test of Polyester Dressing Containing Herbal Extracts and Silver Sulfadiazine Cream Compared with Silver Sulfadiazine Cream in Healing Burn Wounds: A Prospective Randomized Controlled Trial

2021 ◽  
Vol 73 (11) ◽  
pp. 752-757
Author(s):  
Suttipong Tianwattanatada ◽  
Nantaporn Namviriyachote ◽  
Kusuma Chinaroonchai ◽  
Natthida Owattanapanich ◽  
Harikrishna K.R. Nair ◽  
...  
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Pain Score ◽  
Wound Closure ◽  
Silver Sulfadiazine ◽  
Control Group ◽  
Wound Treatment ◽  
Burn Wound ◽  
Hydrocolloid Dressing ◽  
Experimental Group

The standard burn wound treatment is the application of silver zinc sulfadiazine cream, covered with sterilized gauze dressing. This method has been used for decades because of its reasonable costs and applicability for larger wound sizes. However, gauze with a large pore size may stick to the wound bed and cause wound trauma, leading to delayed healing. The patient may also experience additional pain during changing the dressing. The non-adherent property of a hydrocolloid dressing coated with herbal extract (SIHERB) can promote wound healing as well as reduce pain. This study compared the two methods of burn wound treatment in the same patients, who were split into a “treatment group”, who were applied both silver sulfadiazine cream and hydrocolloid dressing, and “control group”, who were applied only silver sulfadiazine cream. The studied outcomes were the number of days for wound closure, the percentage epithelialization, and the pain score (evaluated every three days until epithelialization was completed). In total, 24 patients at the Burn Clinic, Siriraj Hospital were enrolled on this study. The starting wound areas were ranged from 210–220 cm2. The treatment group exhibited significant results regarding faster wound healing, referring to the number of days taken for wound closure (18 days in the control group vs. 15 days in the experimental group) and the percentage epithelialization compared to the control group. The average pain score in the experimental group was also lower on days 9, 12, and 15 after treatment (p < 0.05). No adverse effects were observed during the study. In conclusion, the combination of hydrocolloid dressing and silver sulfadiazine cream could reduce the wound shearing force and wound bed injury, accelerating the rate of wound closure and decreasing the pain during changing the dressing. This technique could improve upon the standard burn wound treatment.

Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

2020 ◽  
Author(s):  
Domenico Pagliara ◽  
Maria Lucia Mangialardi ◽  
Stefano Vitagliano ◽  
Valentina Pino ◽  
Marzia Salgarello
Keyword(s):  
Comparative Study ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Tactile Sensitivity ◽  
Aesthetic Outcome ◽  
Propeller Flap ◽  
Thickness Skin ◽  
Anterolateral Thigh ◽  
Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

scholarly journals Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Lu ◽  
Ke-Chung Chang ◽  
Che-Ning Chang ◽  
Dun-Hao Chang
Keyword(s):  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Salvage Procedure ◽  
Primary Defect ◽  
Scalp Defects ◽  
Thickness Skin ◽  
Scalp Defect ◽  
Secondary Defect

Abstract Background Scalp reconstruction is a common challenge for surgeons, and there are many different treatment choices. The “crane principle” is a technique that temporarily transfers a scalp flap to the defect to deposit subcutaneous tissue. The flap is then returned to its original location, leaving behind a layer of soft tissue that is used to nourish a skin graft. Decades ago, it was commonly used for forehead scalp defects, but this useful technique has been seldom reported on in recent years due to the improvement of microsurgical techniques. Previous reports mainly used the crane principle for the primary defects, and here we present a case with its coincidental application to deal with a complication of a secondary defect. Case report We present a case of a 75-year-old female patient with a temporoparietal scalp squamous cell carcinoma (SCC). After tumor excision, the primary defect was reconstructed using a transposition flap and the donor site was covered by a split-thickness skin graft (STSG). Postoperatively, the occipital skin graft was partially lost resulting in skull bone exposure. For this secondary defect, we applied the crane principle to the previously rotated flap as a salvage procedure and skin grafting to the original tumor location covered by a viable galea fascia in 1.5 months. Both the flap and skin graft healed uneventfully. Conclusions Currently, the crane principle is a little-used technique because of the familiarity of microsurgery. Nevertheless, the concept is still useful in selected cases, especially for the management of previous flap complications.

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