Efficacy of Mepliex ® Ag Versus Xeroform ® As A Split-Thickness Skin Graft Donor Site Dressing: Bad Habits Die Hard.

Autor: Lisiecki JL; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Buta MR; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Taylor S; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Tait M; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Farina N; Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA., Levin J; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Schulz J; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Sangji N; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Friedstat J; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Hemmila MR; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Wang S; Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA., Levi B; Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA., Goverman J; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Annals of burns and fire disasters [Ann Burns Fire Disasters] 2023 Sep 30; Vol. 36 (3), pp. 243-250. Date of Electronic Publication: 2023 Sep 30 (Print Publication: 2023).
Abstrakt: Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform ® or Mepilex ® Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex ® Ag group and 11.4% in the Xeroform ® group (p<0.0001). Patients with Xeroform ® donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex ® Ag and Xeroform ® groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex ® Ag) should be the standard of care in STSG donor site wound care.
(© 2023 Euro-Mediterranean Council for Burns and Fire Disasters.)
Databáze: MEDLINE
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