Collagen Dressing Versus Conventional Vaseline Gauze Dressing in Reducing Pain and Infection at the Donor Area for Skin Grafting: A Prospective Interventional Study

Abstract

Introduction: The harvest of a split thickness skin graft causes a partial thickness injury and an outflow of blood and protein rich exudate from the donor site wound. Conventionally, closed dressings are employed using petroleum jelly impregnated gauge which are permeable to bacteria and wound exudate soaks through. This may lead to pain and infection of the donor site. Biological dressings create the most physiological interface between the wound surfaces and the environment and also dressings are natural, non immunogenic, non pyrogenic and hypo allergenic. Collagen sheet is one such dressing material used. Aim: To compare the conventional dressing using petroleum jelly impregnated gauze versus biological dressing with collagen sheets in terms of pain, infection and healing at skin graft site. Materials and Methods: It was a prospective interventional study conducted in Department of Surgery, SSG Hospital and Medical College, Baroda, Gujarat, India over a period of November 2012 to November 2017 on 220 participants. Randomisation was done by choosing an envelope containing cards marked ‘A’ or ‘B’. The group A (110) was a study group with collagen sheet dressing while group B (110) was the control group with conventional vaseline gauze dressing. Both group patients were examined at six hours postoperatively and then two times a day at 8:00 am and 8:00 pm daily. They were evaluated for pain with Visual Analogue Scale (VAS) score, infection, haematoma formation, healing at donor site and allergic reaction to collagen. Results: Mean VAS score for pain showed that it decreased over a period of time in both the groups. The group with collagen sheet dressing shows decreasing means VAS score from 4.34 on 1st day to 0.29 on 3rd day (p<0.0001). Similarly, the vaseline gauze dressing shows decreasing mean VAS score from 5.64 on 1st day to 1.39 on 3rd day (p<0.0001). Conclusion: Collagen sheet dressing are easy to apply, with advantage of less pain at donor site and lower infection rate. Also healing time required is less than the vaseline gauze dressing. collagen sheet dressing is clinically more efficient overall.