Background and Aims: Skin grafting is the single most effective method to close a chronic wound. The current standard of care is to use meshed split thickness skin grafts. This entails the use of surgical instruments that need to be autoclaved and to have a power source, which usually requires an OR facility. The minced skin technique uses single use, presterilized instruments and the procedure can be done under local anesthesia, by a wound care practitioner, in a wound clinic, a physician's office or even at the bedside. The current study was designed to determine if the results from micrografting were non inferior to conventional mesh grafting.Methods: In a prospective non inferiority study, 26 chronic ulcers were treated with micrografting (MSG) and 24 with conventional mesh grafts 1:3 (control group-CG) in a total of 21 patients, 10 male and 11 female. The donor site areas in the MSG group were predetermined to 2.5 × 5 cm and the mesh grafts expansion was set at 1:3. Results:In the first weeks postoperatively, micrograft healing initially lagged behind the conventional mesh grafts but at 60 days after grafting, all MSG wounds were healed. The MSG wounds had better pigmentation, less itching, and less scarring.The micrografting procedure was easy to learn and expeditious to perform. The MSG mean expansion was 9.1 compared to three times (CG). Conclusion:The MSG procedure is not inferior to conventional mesh grafting, requires smaller donor sites, and can be done with single use instruments, under local anesthesia, with early discharge.

Introduction The collagen plus alginate dressings for donor sites have been used in our country since 2003. Before that, the use of rayon was the main and only preference of use. We were looking for something new at that time that could be less painful and maybe presented a good relation cost-benefit. This alternative dressing seemed to offer collagen to the wound so that the imbalance of metalloproteases would be reduced. We started a study to evaluate the use of collagen calcium-alginate dressing for donor sites. Methods A prospective clinical study was conducted for 2010 to 2017, when this material was donated (high cost in our service). Patients were selected consecutively and randomly allocated into three groups according to the treatment used on the donor site: rayon soaked in 0.9% saline; rayon covered with sterile cotton gauze and bandage; 90% bovine collagen with 10% calcium-alginate dressing covered with transparent polyurethane film. Following parameters was comparatively analyzed: pain, time to epithelialization, length of stay and costs. Results We studied 30 patients, ranging from 12 to 60 years of age. Fifteen of these patients had their donor sites covered with collagen calcium-alginate dressing, which showed pain reduction of 79.5% (p< 0.01) shorter hospital stay and epithelialization, average of 5.8 days (p< 0.01) and reduction in hospital costs about 47% (p< 0.01) in comparison with rayon dressing. None presented infection in the donor site. Conclusions Collagen calcium-alginate dressing showed better cost-benefit than rayon to cover donor sites, with significant reduction of pain, epithelialization time, length of stay and costs. Applicability of Research to Practice cost-effective dressings and painless dressings, Burn care units, Ambulatory care.

Introduction Facial burns are extremely important biological dressings have been developed as temporary substitutes for human skin to avoid infection and accelerate tissue repair, with comfort to the patient. The biocellulose film is produced by the bacterium Acetobacter xylinium. After dehydration process, the obtained product turns into a film. We also use the celluloses film hydrated. Aim: To show the experience of the use of a biocellulose membrane in our hospital, for facial superficial second degree burns.x’x’ Methods This study took place from January 2009 till December 2017. We selected forty five patients with facial superficial second degree burns treated with a biocellulose film since day one post burn. It remained on the face until the complete epithelialization and spontaneous detachment. We studied 45 patients (25 children and 20 adults). We evaluated the final healing time, the pain, the dressing changes and the facility of application (notes from 0 to 10). Results The evaluation note for the ease of application varied from 7 and 8 (40%) and 9 to 10 (60%). We saw spontaneous detachment of the dressing in all cases till day 10. The grade of pain varied from 0 to 2. After day 4 no one referred pain. The full epithelization occurred in 8 days in 90% of children and in 10 days in the other 10% of the children. The restoration in the adults followed t the same pattern. Conclusions The biocellulose dressing seems to be a good option for superficial facial burns. It is painless, easy to apply and has a good cost benefit relation. The authors suggest longer randomized studies. Applicability of Research to Practice New technologies that are cheape, less painfull and efective can be of a great value not only for us but for everyone who work with burn patients.