A comparative study of chlorhexidine-coated tulle gras versus polyurethane adhesive film for donor site wound dressing in split skin graft cases
DOI:
https://doi.org/10.18203/2320-6012.ijrms20241959Keywords:
Dressing, Skin grafting, Wound, Opsite, CTGAbstract
Background: Restoration of the skin barrier after wounding prevents infection, and minimises wound contraction, cosmetic disfigurement and volume depletion. Skin grafting represents an effective solution for large skin defects. Optimum care for donor-site wounds should promote wound healing cost-effectively while preventing complications like pain, infection, and scarring. Healthcare professionals use various dressings and topical agents, but there is no ideal dressing. In our study, we aim to compare the efficacy of chlorhexidine coated tulle gras (CTG) and polyurethane adhesive film (Opsite) in managing donor site wounds in split skin grafts.
Methods: This study was conducted at the Department of Surgery, Lokmanya Tilak Municipal Medical College, a teaching hospital and tertiary care centre in Mumbai, from September 2012 to December 2014, following a prospective observational design, with a sample size of 50 patients.
Results: The study subjects were predominantly in the 20-30 age group (36.0%) and mostly male (72.0%). The Opsite group reported significantly higher comfort scores (56.0%) compared to the CTG group (36.0%, p=0.002). Healing time was significantly shorter in the Opsite group (7.36±0.7 days) compared to the CTG group (9.52±1.39 days, p=0.001). Pain scores were significantly lower in the Opsite group at all observed times. Deviations like soakage and slippage were frequent in the Opsite group (76.0% and 56.0%, respectively).
Conclusions: Opsite has advantages over CTG viz. faster healing and re-epithelization, decreased pain, and greater comfort. However, soakage and exudate formation are seen with Opsite.
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References
Lopez-Ojeda W, Pandey A, Alhajj M, Oakley AM. Anatomy, Skin (Integument). In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.
Braza ME, Fahrenkopf MP. Split-Thickness Skin Grafts. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.
Ratner D. Skin grafting. Semin Cutan Med Surg. 2003;22(4):295-305.
Olawoye OA, Ademola SA, Iyun AO, Michael AI, Oluwatosin OM. Management of split skin graft donor site in the West African sub region: survey of plastic surgeons’ practice. Ann Burns Fire Disasters. 2017;30(2):146-9.
Rakel BA, Bermel MA, Abbott LI, Baumler SK, Burger MR, Dawson CJ, et al. Split-thickness skin graft donor site care: a quantitative synthesis of the research. Appl Nurs Res ANR. 1998;11(4):174-82.
Wiechula R. The use of moist wound-healing dressings in the management of split-thickness skin graft donor sites: a systematic review. Int J Nurs Pract. 2003;9(2):S9-17.
Voineskos SH, Ayeni OA, McKnight L, Thoma A. Systematic review of skin graft donor-site dressings. Plast Reconstr Surg. 2009;124(1):298-306.
Schreuder S, Qureshi M, Vermeulen H, Ubbink D. Dressings and Topical Agents for Treating Donor Sites of Split-Skin Grafts: A Systematic Review Extended abstract. EWMA J. 2009;9:22.
Persson K, Salemark L. How to dress donor sites of split thickness skin grafts: a prospective, randomised study of four dressings. Scand J Plast Reconstr Surg Hand Surg. 2000;34(1):55-9.
Barnett A, Berkowitz RL, Mills R, Vistnes LM. Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites. Am J Surg. 1983;145(3):37981.
Iregbulem LM. Use of a semi-permeable membrane dressing in donor sites in Nigerians. Ann Acad Med Singapore. 1983;12(2):425-9.
Yadav JK, Singhvi AM, Kumar N, Garg S. Topical phenytoin in the treatment of split-thickness skin autograft donor sites: a comparative study with polyurethane membrane drape and conventional dressing. Burns J Int Soc Burn Inj. 1993;19(4):306-10.
Dornseifer U, Lonic D, Gerstung TI, Herter F, Fichter AM, Holm C, et al. The ideal split-thickness skin graft donor-site dressing: a clinical comparative trial of a modified polyurethane dressing and aquacel. Plast Reconstr Surg. 2011;128(4):918-24.