Split-Thickness Skin Graft Donor Site Management: A Randomized Prospective Trial Comparing a Hydrophilic Polyurethane Absorbent Foam Dressing With a Petrolatum Gauze Dressing
Autor: | Patti Hankins, David L. Callender, Randal S. Weber, Helmuth Goepfert, Robert M. Frankenthaler, Ellen Limitone, Pat Wolf |
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Rok vydání: | 1995 |
Předmět: |
Male
Surgical Sponges medicine.medical_specialty Petrolatum Polyurethanes Epithelium Permeability Absorption chemistry.chemical_compound Split thickness skin graft medicine Humans Surgical Wound Infection Prospective Studies Graft donor Site management Pain Measurement Skin Polyurethane Pain Postoperative Wound Healing Emollients integumentary system business.industry Head neck Water Skin Transplantation General Medicine Middle Aged Bandages Surgery Thigh Otorhinolaryngology chemistry Prospective trial Head and neck surgery Female business Follow-Up Studies |
Zdroj: | Archives of Otolaryngology - Head and Neck Surgery. 121:1145-1149 |
ISSN: | 0886-4470 1145-1149 |
Popis: | Objective: Traditionally, skin graft donor sites have been covered with fine-mesh gauze dressings, and a dry eschar has been allowed to form. Newer dressings that can provide a moist wound environment may facilitate reepithelialization. We compared a hydrophilic semipermeable absorbent polyurethane foam dressing that provides a moist wound environment with a petrolatum gauze dressing for donor sites. Design: Prospective randomized trial; follow-up at 14 days. Setting: Department of head and neck surgery in a tertiary care center. Patients: Sixty-eight eligible patients received one of the two dressings. Harvested skin grafts were 0.375-mm (0.015-in) thick; donor site surface areas were recorded. At postoperative day 14, the dressings were removed, and wound epithelialization was scored: 1, none; 2, scattered or spotty; and 3, complete. Donor site and operative site pain intensities were assessed by a visual numeric scale: none (0) to the worst (100) experienced over the preceding 24-hour period. Pain scores were available for 58 patients. Main Outcome Measures: Dressings were compared based on these criteria: healing at 14 days, infection, and donor site and operative site pain. Results: A healing score of 3 was seen in 37% (14/38) of patients with hydrophilic semipermeable absorbent polyurethane foam dressings and in 17% (5/30) of patients with petrolatum gauze dressings ( P =.06) by day 14. Overall, however, mean healing scores were similar in both groups. Mean healing scores for the patients who received a hydrophilic semipermeable absorbent polyurethane foam dressing was 2.3 (SD=0.6) vs 2.2 (SD=0.6) for patients who received the petrolatum gauze dressing ( P =.20). Numbers of days required for complete epithelialization in these groups were 20.6 (SD=10.1) and 19.3 (SD=5.1), respectively ( P =.49). One infection occurred in the group who received the petrolatum gauze dressing. The mean maximum pain intensity scores were lower for those who were given the hydrophilic semipermeable absorbent polyurethane foam dressing on postoperative days 1 through 3 ( P =.003,.03, and.04, respectively). Pain increased with a larger donor site surface area for the patients with the petrolatum gauze dressing but not for the patients with the hydrophilic semipermeable absorbent polyurethane foam dressing. Conclusions: The hydrophilic semipermeable absorbent polyurethane foam dressing appears to have potential advantages over the petrolatum gauze dressing: it produces less initial patient donor site discomfort and tends to produce more complete donor site healing by postoperative day 14. (Arch Otolaryngol Head Neck Surg. 1995;121:1145-1149) |
Databáze: | OpenAIRE |
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