Split-thickness skin graft donor-site morbidity: A systematic literature review

Asuku, Malachy; Yu, Tzy‐Chyi; Qi, Yan; Boing, E.; Hahn, Helen; Hovland, Sara; Donelan, Matthias B.

doi:10.1016/j.burns.2021.02.014

Cited by 72 publications

(65 citation statements)

References 92 publications

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“…This process of wound healing might seem uneventful, but still includes the morbidity of pain and itching. Sometimes it may even be associated with abnormal pigmentation, erythema, and unfavorable scarring [ 5 ]. Despite STSG being a commonly performed procedure, there is a lack of consensus with regards to the recommended method of donor site management.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Donor site morbidity of STSG is usually minimal, but that may not always be the case [ 5 ]. Morbidity may include pigmentary anomalies or dyschromia, prolonged pain, delayed healing, or unfavorable scarring [ 5 ]. So, an effort must be taken to find the optimal solution for donor site healing and minimize morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting

Chalwade¹,

Kumar²,

Suresh³

2022

Cureus

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Background The morbidity of the donor site in split-thickness skin graft (STSG) may include abnormal pigmentation, delayed healing, and unfavorable scarring. Studies are usually focused on improving the healing of the recipient site, so donor site management becomes a secondary consideration. An optimal solution should be sought for donor site management to improve healing and minimize morbidity. Methods In this study, we used minced residual skin grafts over half of the donor site (cases) and compared the healing duration and scar quality with the other half (control). Healing duration was measured in days and the scar quality was assessed by the Patient and Observer Scar Assessment Scale (POSAS) at 90 days, 180 days, and 360 days. Results The healing time was reduced with the application of minced residual skin grafts on the donor site. The scar quality was significantly better in the case group as compared to the control group at 90 days, 180 days, and 360 days (p<0.05). Conclusion Mincing residual skin grafts and replacing them back to the donor site reduces the healing time and improves the quality of the scar.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting

Chalwade¹,

Kumar²,

Suresh³

2022

Cureus

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“…Although autografts are preferred for the treatment of acute burn wounds, they create another wound that can lead to pain, scarring, and reduced quality of life. 158 , 159 Additionally, in the case of extensive burn wounds, an individual may not have enough uninjured skin to provide sufficient coverage, creating a need for skin substitutes. 159 There are many different ways to classify skin substitutes.…”

Section: Therapeutics Aimed At Promoting Regenerative Healing In Burn...mentioning

confidence: 99%

Healing Mechanisms in Cutaneous Wounds: Tipping the Balance

Singer

2022

Tissue Engineering Part B: Reviews

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Acute and chronic cutaneous wounds pose a significant health and economic burden. Cutaneous wound healing is a complex process that occurs in four distinct, yet overlapping, highly coordinated stages: hemostasis, inflammation, proliferation, and remodeling. Postnatal wound healing is reparative, which can lead to the formation of scar tissue. Regenerative wound healing occurs during fetal development and in restricted postnatal tissues. This process can restore the wound to an uninjured state by producing new skin cells from stem cell reservoirs, resulting in healing with minimal or no scarring. Focusing on the pathophysiology of acute burn wounds, this review highlights reparative and regenerative healing mechanisms (including the role of cells, signaling molecules, and the extracellular matrix) and discusses how components of regenerative healing are being used to drive the development of novel approaches and therapeutics aimed at improving clinical outcomes. Important components of regenerative healing, such as stem cells, growth factors, and decellularized dermal matrices, are all being evaluated to recapitulate more closely the natural regenerative healing process. Impact Statement Acute wounds from thermal injury are common; they exert substantial physical and psychological effects on a patient and result in significant morbidity and mortality. This review provides a detailed overview of the mechanisms of reparative and regenerative wound healing; discusses the key cell types, signaling molecules, and molecular targets that influence these important biological pathways; and highlights current therapeutic approaches aimed at promoting regenerative wound healing. An increased understanding of the underlying mechanisms of reparative and regenerative healing will contribute to the development of innovative strategies for the clinical treatment of patients with severe burns.

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“…According to a recent systematic literature review, epithelialization of donor sites can last up to 1 month, with moderate to severe pain for up to 3 weeks. 1 In addition, donor-site wounds are at significant risk for infection, bleeding, scarring, hyperpigmentation, or dyspigmentation, with differing frequency reported in literature. 1 To accelerate wound healing, donor sites are covered using different materials.…”

mentioning

confidence: 99%

Use of polylactid acid membrane improves outcome of split-thickness skin graft donor sites: a prospective, comparative, randomized study

Moellhoff

Lettner

Frank

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Polyurethane film dressings are commonly applied for coverage of split-thickness skin graft donor sites, although previous studies have suggested reduced morbidity using a polylactic acid membrane. To further investigate the optimal treatment approach, the authors compared outcomes of donor sites in patients receiving either polylactic acid membrane or polyurethane film. Methods: This randomized clinical trial allocated patients requiring split-thickness skin grafting to receive either polylactic acid membrane or polyurethane film at the donor site. The primary endpoint was difference in donor-site scar appearance between groups 3 months postoperatively, using the Vancouver Scar Scale. Secondary endpoints included pain, number of and time required for wound dressing changes, and costs related to the wound dressing. Results: Thirty patients were allocated to each group. The median Vancouver Scar Scale score was lower for patients receiving polylactic acid membrane [polyurethane film, 3 (interquartile range, 2 to 4); polylactic acid membrane, 2 (interquartile range, 1 to 3); p = 0.049]. Pain during change of wound dressing (polyurethane film, 2.0 ± 0.2; polylactic acid membrane, 0.5 ± 0.2; p < 0.001) and mobilization (polyurethane film, 0.8 ± 0.2; polylactic acid membrane, 0.3 ± 0.1; p = 0.032) were reduced in the polylactic acid membrane group. Patients with polylactic acid membrane required fewer dressing changes per day of hospital stay (polyurethane film, 0.44 ± 0.06; polylactic acid membrane, 0.28 ± 0.02; p = 0.015). Mean time for wound dressing changes per patient was higher in the polyurethane film group (polyurethane film, 74.50 ± 5.72 minutes; polylactic acid membrane, 21.43 ± 2.61 minutes; p < 0.001). Costs were higher in the polylactic acid membrane group (polyurethane film, €67.83 ± €5.56; polylactic acid membrane, €162.79 ± €21.76; p < 0.001). Conclusion: Polylactic acid membrane improves outcome of split-thickness skin grafting donor sites; however, higher treatment costs must be taken into consideration. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

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Split-thickness skin graft donor-site morbidity: A systematic literature review

Cited by 72 publications

References 92 publications

Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting

Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting

Healing Mechanisms in Cutaneous Wounds: Tipping the Balance

Use of polylactid acid membrane improves outcome of split-thickness skin graft donor sites: a prospective, comparative, randomized study

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