Comparison between Aquacel and Aquacel Foam dressing on split-thickness skin graft donor site

2021 ◽  
Vol 30 (Sup12) ◽  
pp. S14-S20
Author(s):  
Su-Hua Chiang ◽  
Xinyi Xu ◽  
Denise Shuk Ting Cheung ◽  
Ying-Hsuan Hsu ◽  
Ching-En Chen ◽  
...  
Keyword(s):  
Pain Score ◽  
Skin Graft ◽  
Large Scale ◽  
Donor Site ◽  
Superior Performance ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Lower Likelihood ◽  
Average Pain ◽  
Average Pain Score

Objective: To compare the effectiveness of two commonly used moist dressings, Aquacel and Aquacel Foam (both ConvaTec Ltd., UK), in managing split-thickness skin graft (STSG) donor site wounds. Method: Patients undergoing STSG harvesting for reconstruction were eligible for this quasi-experimental study. After reconstruction surgery, the Aquacel (A) or Aquacel Foam (AF) dressings were applied on the donor site wound. The STSG donor site was assessed by two trained research nurses daily. Clinical outcomes including pain on dressing removal, use of intravenous analgesics, signs and symptoms of wound infection, incidence of exudate leakage and percentage healed were recorded in a standardised form. Cost of the dressing change was retrieved from the hospital billing system. Results: Of 50 patients recruited, 25 received dressing A and 25 received the AF dressing for their STSG donor site wound. The average pain score on dressing removal was significantly lower in the AF dressing group compared with the A dressing group (0.8±0.8 versus 3.1±1.5, respectively (p=0.04)). Regression analysis demonstrated that compared with dressing A, the AF dressing was associated with a lower average pain score (beta: –2.27, standard error: 0.33; p<0.001), lower likelihood of pro re nata (PRN) intravenous analgesic use (odds ratio (OR)=0.21, 95% confidence interval: 0.06–0.71; p=0.01) and lower likelihood of exudate leakage (OR=0.11, p=0.01). The differences in time to wound healing, infection and cost were not statistically significant between the two groups. Conclusion: In this study, the AF dressing demonstrated superior performance in pain response on dressing removal for STSG donor site wounds compared with dressing A. Large-scale randomised controlled trials should be conducted to confirm the findings.

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.

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.

scholarly journals Split-thickness skin graft donor-site morbidity: A systematic literature review

Burns ◽  
2021 ◽  
Author(s):  
Malachy Asuku ◽  
Tzy-Chyi Yu ◽  
Qi Yan ◽  
Elaine Böing ◽  
Helen Hahn ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Skin Graft ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

Use of Honey as an Adjunct in the Healing of Split-Thickness Skin Graft Donor Site

2003 ◽  
Vol 29 (2) ◽  
pp. 168-172
Author(s):  
AYKUT MISIRLIOGLU ◽  
SINEM EROGLU ◽  
NACI KARACAOGLAN ◽  
MITHAT AKAN ◽  
TAYFUN AKOZ ◽  
...  
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

scholarly journals Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing

2017 ◽  
Vol 5 (5) ◽  
pp. e1339 ◽  
Author(s):  
Brian P. Bradow ◽  
Geoffrey G. Hallock ◽  
Samuel P. Wilcock
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

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.

Effect of Subcutaneous Epinephrine/Saline/Local Anesthetic Versus Saline-Only Injection on Split-Thickness Skin Graft Donor Site Perfusion, Healing, and Pain

2013 ◽  
Vol 34 (2) ◽  
pp. e80-e86 ◽  
Author(s):  
Sigrid Blome-Eberwein ◽  
Michael Abboud ◽  
Daniel D. Lozano ◽  
Rohit Sharma ◽  
Sherrine Eid ◽  
...  
Keyword(s):  
Skin Graft ◽  
Local Anesthetic ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Graft Donor

Use of lyophilized bovine collagen for split-thickness skin graft donor site management

Burns ◽  
2008 ◽  
Vol 34 (7) ◽  
pp. 1011-1014 ◽  
Author(s):  
Fatih Uygur ◽  
Rahmi Evınc ◽  
Ersin Ulkur ◽  
Bahattin Celıkoz
Keyword(s):  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Site Management ◽  
Bovine Collagen ◽  
Thickness Skin ◽  
Graft Donor

A novel Split-Thickness Skin Graft Donor Site

2009 ◽  
Vol 141 (3) ◽  
pp. 390-394 ◽  
Author(s):  
Tamer A. Ghanem ◽  
Mark K. Wax
Keyword(s):  
Skin Graft ◽  
Reverse Flow ◽  
Donor Site ◽  
Tertiary Care ◽  
Case Series ◽  
Free Flaps ◽  
Split Thickness Skin Graft ◽  
Skin Paddle ◽  
Forearm Flap ◽  
Thickness Skin

OBJECTIVE: To eliminate morbidity of the thigh split-thickness skin graft (STSG) donor site in forearm flaps, the feasibility of harvesting from an alternate site was assessed. STUDY DESIGN: Case series with planned data collection. SETTING: A tertiary care academic setting. SUBJECTS AND METHODS: Data were collected from patients undergoing forearm flap reconstruction over 13 months. The forearm flap harvesting procedure was modified to incorporate STSG harvest directly from the flap skin paddle. RESULTS: There were 66 patients in this cohort, with mean age of 62.6 years. There were 58 fasciocutaneous radial forearm free flaps (RFFFs), three osteocutaneous RFFF, three ulnar flaps, and two reverse-flow RFFFs. The majority of flaps were used for mucosal coverage (n = 54), but 12 flaps were used for external skin coverage. The mean forearm defect was 36.5 cm2 (12–77 cm2). Harvesting from the forearm skin paddle was successful in 64 patients (97%). Two patients required a thigh STSG; both patients were octogenarians with frail skin. CONCLUSION: A thigh STSG donor site, with its associated morbidities, can be eliminated in 97 percent of patients undergoing forearm flaps. Older patients with frail skin may require a thigh donor site.

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