Randomized clinical trial of donor‐site wound dressings after split‐skin grafting1. Issue 5 (24th January 2013)

• Record Type: Journal Article
• Authors: Brölmann, F. E.; Eskes, A. M.; Goslings, J. C.; Niessen, F. B.; de Bree, R.; Vahl, A. C.; Pierik, E. G.; Vermeulen, H.; Ubbink, D. T.
• Is Part Of: British journal of surgery. Volume 100:Issue 5(2013:May)
• Page Start: 619
• Page End: 627
• Publication Date: 2013-01-24
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.9045
• Languages: English
• ISSNs: 0007-1323

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background</title> <p>The aim was to study which dressing material was best for healing donor‐site wounds (DSWs) after split‐skin grafting as there is wide variation in existing methods, ranging from classical gauze dressings to modern silicone dressings.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Methods</title> <p>This 14‐centre, six‐armed randomized clinical trial (stratified by centre) compared six wound dressing materials in adult patients with DSWs larger than 10 cm<sup>2</sup>. Primary outcomes were time to complete re‐epithelialization and pain scores measured on a visual analogue scale (VAS) over 4 weeks. Secondary outcomes included itching (VAS, over 4 weeks), adverse events and scarring after 12 weeks rated using the Patient and Observer Scar Assessment Scale (POSAS).</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results</title> <p>Between October 2009 and December 2011, 289 patients were randomized (of whom 288 were analysed) to either alginate (45), film (49), gauze (50), hydrocolloid (49), hydrofibre (47) or silicone (48) dressings. Time to complete re‐epithelialization using hydrocolloid dressings was 7 days shorter than when any other dressing was used (median 16 <italic>versus</italic> 23 days; <italic>P</italic> < 0·001). Overall pain scores were low, and slightly lower with use of film dressings (<italic>P</italic> = 0·038). The infection rate among patients treated with gauze was twice as high as in those who had other dressings (18 <italic>versus</italic> 7·6 per cent; relative risk 2·38, 95 per cent confidence interval 1·14 to 4·99). Patients who had a film dressing were least satisfied with overall scar quality.</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Conclusion</title> <p>This trial showed that use of hydrocolloid dressings led to the speediest healing of DSWs. Gauze dressing should be discontinued as they caused more infections. Registration number: NTR1849 (http://www.trialregister.nl).</p> </sec> </abstract>