Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model

Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.; Pierce, Lisa

doi:10.1097/gox.0000000000000031

Cited by 20 publications

(14 citation statements)

References 32 publications

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“…Although we only observed minor differences between the silk fibroin film group and other control groups, our data reached the U.S. FDA requirements for a newly developed biomedical product to demonstrate substantial equivalence to the predicate devices. To our knowledge, the silk fibroin material has never been evaluated in a large animal model for the treatment of wound defects, precluding a direct comparison between our silk fibroin film with other silk wound dressings. Nevertheless, our data obtained from the rabbit and porcine studies provide substantial evidence of the safety and effectiveness of the silk fibroin film for treatment of skin defects, which is ready for clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Silk Fibroin Biomaterial Shows Safe and Effective Wound Healing in Animal Models and a Randomized Controlled Clinical Trial

Zhang

Chen

et al. 2017

Adv Healthcare Materials

225

170

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Due to its excellent biological and mechanical properties, silk fibroin has been intensively explored for tissue engineering and regenerative medicine applications. However, lack of translational evidence has hampered its clinical application for tissue repair. Here a silk fibroin film is developed and its translational potential is investigated for skin repair by performing comprehensive preclinical and clinical studies to fully evaluate its safety and effectiveness. The silk fibroin film fabricated using all green chemistry approaches demonstrates remarkable characteristics, including transmittance, fluid handling capacity, moisture vapor permeability, waterproofness, bacterial barrier properties, and biocompatibility. In vivo rabbit full-thickness skin defect study shows that the silk fibroin film effectively reduces the average wound healing time with better skin regeneration compared with the commercial wound dressings. Subsequent assessment in porcine model confirms its long-term safety and effectiveness for full-thickness skin defects. Finally, a randomized single-blind parallel controlled clinical trial with 71 patients shows that the silk fibroin film significantly reduces the time to wound healing and incidence of adverse events compared to commercial dressing. Therefore, the study provides systematic preclinical and clinical evidence that the silk fibroin film promotes wound healing thereby establishing a foundation towards its application for skin repair and regeneration in the clinic.

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Section: Discussionmentioning

confidence: 99%

Silk Fibroin Biomaterial Shows Safe and Effective Wound Healing in Animal Models and a Randomized Controlled Clinical Trial

Zhang

Chen

et al. 2017

Adv Healthcare Materials

225

170

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“…STSG is one of the most common techniques for the replacement of skin damaged following burns [10,11] because it has many benefits such as fast healing, acceptable scar, and low complications [11][12][13]. A partialthickness wound is created in the skin graft donor site that is healed by re-epithelialization.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Different Methods of Dressing for Skin Graft Donor Site

Aghdam

Alizadeh

Toomatari

et al. 2020

Int J Med Toxicol Forensic Med

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Background: There are various methods to dress the Skin Graft Donor Site (SGDS), but some are very expensive and not available in Iran. This study aimed to compare three different dressings for the management of the SGDS.Methods: Ninety-six patients participated in the study, and they were randomly divided into three groups. Donor sites were dressed with one of these methods: Vaseline gauze or method A, mupirocin 2% or method B, and nitrofurazone or method C. In each method, the dressing layer was covered by 5 layers of dry gauze. The three groups were compared regarding the epithelialization time, infection, pain, and cost.Results: The epithelialization time was significantly longer in group A compared with groups B and C (P<0.05), but there was no significant difference between groups B and C (P<0.05). There was no significant difference between the three groups in infection and pain at rest, activity, and dressing time (P<0.05). There was a substantial difference between the three groups in the cost of dressing as method A was cheaper.Conclusion: Due to the lower cost of Vaseline gauze and no significant difference in infection, dressing adhesion to the skin, and amount of pain between three dressing methods, Vaseline gauze is a preferred method to skin graft donor site dressing.

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“…Some studies comparing various dressings suggest options such as duoderm and Xeroform are among the best dressing options. 19–23 …”

Section: Discussionmentioning

confidence: 99%

Back Grafting the Split-Thickness Skin Graft Donor Site

Goverman

Kraft

Fagan

et al. 2017

Journal of Burn Care & Research

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Split-thickness skin grafting is a useful method of wound repair in burn and reconstructive operations. However, skin grafts require a donor site injury that creates a secondary wound at risk for delayed wound healing. Though in young healthy patients such donor sites have minimal risk, patients with risk factors for delayed wound healing are more challenging. We present a method for graft donor site management that offers an alternative to healing by secondary intention for patients with higher risk of poor wound healing. In those patients considered to be at high risk for donor site healing complications, we chose to treat the donor site with a split-thickness skin graft, or “graft back” procedure. An additional graft is taken adjacent to the initial donor site, and meshed 4:1 to cover both donor sites at once. Out of the 17 patients who received this procedure, 1 patient had a complication from the procedure that did not require an operation, and all patients appear to have good functional and cosmetic outcomes. No patients had any graft loss or graft infection. Histologic analysis showed complete epithelialization of the back-grafted area. The graft back method converts an open wound to a covered wound and may result in decreased wound healing time, improved cosmetic outcomes, and fewer complications, particularly in patients where wound healing is a concern. Importantly, it seems to have minimal morbidity. More detailed prospective studies are needed to ensure no additional risk is incurred by this procedure.

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Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model

Cited by 20 publications

References 32 publications

Silk Fibroin Biomaterial Shows Safe and Effective Wound Healing in Animal Models and a Randomized Controlled Clinical Trial

Silk Fibroin Biomaterial Shows Safe and Effective Wound Healing in Animal Models and a Randomized Controlled Clinical Trial

Comparison of Three Different Methods of Dressing for Skin Graft Donor Site

Back Grafting the Split-Thickness Skin Graft Donor Site

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