Health‐related quality of life and patient burden in patients with split‐thickness skin graft donor site wounds

Humrich, Marco; Goepel, Lisa; Gutknecht, Mandy; Lohrberg, David; Blessmann, Marco; Bruning, Guido; Diener, Holger; Dissemond, Joachim; Hartmann, Bernd; Augustin, Matthias

doi:10.1111/iwj.12860

Cited by 17 publications

(7 citation statements)

References 13 publications

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“…STSG has become one of most used technique to treat skin loss due to various reasons. Burns are considered one of major reasons [15]. In this study the majority (95%) of cases were due to burns that resulted in full skin loss and necessitate coverage by STSG.…”

Section: Discussionmentioning

confidence: 75%

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Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft

Elsherbeny

Elshahat

Gad

2023

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: Split-thickness grafts (STSGs) harvesting is a common technique to reconstruct absent skin and to reestablish the skin barrier in burn and skin defects. Donor site morbidity is not uncommon. Various materials and dressings had been used to improve healing of donor site. Fat grafting or its components had been used in promotion of healing in chronic and irradiated wounds indicating the possibility of improving healing.Objective: To evaluate the effect of adding nano fat grafts to donor sites of STSGs.Patients and Methods: Twenty (20) adult patients were included in this comparative self-controlled clinical trial from March 2020 to April 2021. These patients had raw areas of skin needing STSG. STSG thickness was 0.12.5 inch leaving an area measuring 7x15cm (105cm 2 ) at the donor site. The donor site area in the lower limb was used as a test area where it was divided into two equal areas, one area was covered by nano fat graft and Vaseline gauze (group A), the other acting as a control group was covered by Vaseline gauze only (group B). Group A was compared to group B as regard healing time from 10 th day onward and quality of healing after one month using Vancouver scale (VSS). Tissue biopsy was taken at day 21 from both groups. Any Donor site complications were noted.Results: Comparing The rate of donor site healing in group A with group B, group A showed faster healing with a mean of (13.30±2.61) versus (16.05±2.43) days from the date of harvesting of STSG. Histologically the mean thickness of neo epithelium in group A was more than that of group B with a mean value of 255.04±15.27µm and 161.15±28.75µm consecutively. Group A showed better vascularity and pliability while no difference was detected as regard pigmentation and height. Infection occurred in donor site of one patient.Conclusions: Using topical nano fat graft and Vaseline gauze on the donor site of STSG improves healing time as well as vascularity and pliability in comparison to Vaseline gauze alone.

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Section: Discussionmentioning

confidence: 75%

“…In one survey patients reported an average of 15.6 up to 33.8 days they could not go to work due to the donor-site wound. 15 The using of nano fat graft was not only beneficial in decreasing healing time of donor area but it was responsible for a better epithelial thickness (Fig. 7).…”

Section: Discussionmentioning

confidence: 95%

Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft

Elsherbeny

Elshahat

Gad

2023

The Egyptian Journal of Plastic and Reconstructive Surgery

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“…Humrich and colleagues13 conducted a multicenter, observational, cross-sectional study of 112 adult patients with split-thickness skin graft (STSG) donor-site wounds to evaluate HRQoL related to acute donor-site wounds following split-thickness skin grafting. Most indications for skin grafting were postsurgical treatment (n = 51; 42.5%) and chronic wounds (n = 47; 39.2%) 12.…”

Section: Discussionmentioning

confidence: 99%

Impact of Complex Wounds on Health-Related Quality of Life

Ratliff¹,

Rovnyak²

2021

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: To describe health-related quality of life (HRQoL) using the Wound-Quality of Life (Wound-QoL) questionnaire for those individuals referred to an academic medical center wound clinic. DESIGN: Prospective, descriptive study. SUBJECTS AND SETTING: One hundred eleven participants receiving care in an academic medical center wound clinic in the Southeastern United States. The sample comprised 67 males (60.4%) and 44 females (39.6%) with wounds of 6 major etiologies. METHODS: From June 2019 through May 2020, a convenience sample of 111 individuals completed the Wound-QoL questionnaire at the initial visit to the wound clinic. The Wound-QoL questionnaire is a valid and reliable tool consisting of 17 questions related to wound-QoL measured on a 5-point Likert scale, ranging from 0 (not at all affected) to 4 (very much affected). The questions are assigned to the 3 subscales: “body,” “psyche,” and “everyday life.” The Wound-QoL individual items, subscales, and the total wound score (TWS) were calculated as mean values of the item scores, ranging from 0 to 4, where higher values correspond to decreased HRQoL. The TWS is defined as the sum of the 17 item responses, with values ranging from 0 to 68. Descriptive and parametric statistics were used to analyze the data from the Wound-QoL questionnaire. RESULTS: The mean TWS was approximately 3 points higher for Whites (n = 84) than for Blacks (n = 27) (32.42, SD = 17.96 vs 29.51, SD = 19.39), but this difference was not significant (P = .473). An independent-samples t test of TWS versus sex was not significant (P = .446). The TWS by age category was significant (P = .015), showing differences in mean scores based on age category. We found that the youngest (ages 17-39 years) and oldest (ages 70-98 years) participants were less bothered by their wounds in almost all respects than those in the middle age range (ages 40-69 years). The individual item means varied between 0.84 and 2.72, out of a possible range of 0 to 4. The highest means were for items on the emotional subscale with means from 1.93 to 2.72. Analysis of variance was used to examine the TWS and the 3 subscales over the 6 wound types; none were found to be significant (TWS: P = .454, body: P = .722, psyche: P = .452, everyday life: P = .087). CONCLUSION: Wound-QoL questionnaire scores indicated that the greatest impact of a wound on HRQoL was on the emotional subscale. These 4 items are related to the individual expressing worry, fear, unhappiness, or frustration with wound healing. The Wound-QoL questionnaire may be used to evaluate the impact the wound has on the individual's HRQoL.

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“…Donor site pain is one of the most distressing symptoms reported by skin graft patients in the early postoperative period 15 and is reported to impair patients' everyday activities. 16 Several publications discuss the management of donor site wound care but fail to appropriately document the pain related to the harvesting of STSGs and FTSGs. It has been suggested that patients have difficulty reporting their donor site-related pain likely due to their perception of pain from the primary wound.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Donor Site Pain After Fractional Autologous Full-Thickness Skin Grafting

Jaller

Herskovitz

Borda

et al. 2018

Advances in Wound Care

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Background: Despite the development of numerous wound treatment alternatives, 25% to 50% of leg ulcers and >30% of foot ulcers are not fully healed after 6 months of treatment. Autologous skin grafting is a time-tested therapy for these wounds; however, the creation of a new wound in the donor area yields a considerable limitation to this procedure.Innovation: Fractional autologous full-thickness skin grafting (FFTSG) is a technique wherein multiple small full-thickness skin grafts (FTSGs) are harvested with possibly minor donor-site comorbidities. The first device used to harvest FFTSG (ART™ system, Medline, Northfield, IL) is a device capable of harvesting >300 small FTSGs and transferring them to a target wound.Objective: To better evaluate patients' clinical experience, we sought to evaluate pain at the donor site associated with this procedure.Approach: Pain was assessed with numeric visual analog pain scales at days 1, 2, 4, and 7. Nine subjects underwent this procedure with only six of them reporting any level of pain on day 1, and none disclosing pain after day 2.Conclusion: In this study, we evidenced that this device manages to harvest FTSGs with minimal associated pain. Future research will need to evaluate other aspects of the procedure as well as long-term outcomes at the donor and recipient areas.

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Health‐related quality of life and patient burden in patients with split‐thickness skin graft donor site wounds

Cited by 17 publications

References 13 publications

Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft

Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft

Impact of Complex Wounds on Health-Related Quality of Life

Evaluation of Donor Site Pain After Fractional Autologous Full-Thickness Skin Grafting

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