Management of Split-Thickness Skin Graft Donor Sites: A Randomized Controlled Trial of Calcium Alginate versus Polyurethane Film Dressing

Läuchli, Severin; Hafner, Jürg; Ostheeren, Sonja; Mayer, Dieter; Barysch, Marjam J.; French, Lars E.

doi:10.1159/000356122

Cited by 26 publications

(30 citation statements)

References 28 publications

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“…It has various medical applications as wound dressing, dental impression, and in cell culture. In one randomized controlled study by Läuchli's team (12) on the use of calcium alginate versus polyurethane film dressing for wound management in skin graft donors, the alginate dressing required fewer dressing changes and less leakage of exudates. Alginate hydrogels were prepared physically by repeated freeze and thawing (13) or chemically via ionotropic gelation using polyelectrolytes (14).…”

Section: Introductionmentioning

confidence: 99%

An Investigation and Characterization on Alginate Hydogel Dressing Loaded with Metronidazole Prepared by Combined Inotropic Gelation and Freeze-Thawing Cycles for Controlled Release

Sarheed

Rasool²,

Abu‐Gharbieh

et al. 2014

AAPS PharmSciTech

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Abstract. The purpose of this study was to investigate the effect of combined Ca 2+ cross-linking and freeze-thawing cycle method on metronidazole (model drug) drug release and prepare a wound film dressing with improved swelling property. The hydrogel films were prepared with sodium alginate (SA) using the freeze-thawing method alone or in combination with ionotropic gelation with CaCl 2 . The gel properties such as morphology, swelling, film thickness, and content uniformity and in vitro dissolution profiles using Franz diffusion cell were investigated. The cross-linking process was confirmed by differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) spectroscopy. In vitro protein adsorption test, in vivo wound-healing test, and histopathology were also performed. The hydrogel (F2) composed of 6% sodium alginate and 1% metronidazole prepared by combined Ca 2+ cross-linking and freeze-thawing cycles showed good swelling. This will help to provide moist environment at the wound site. With the in vivo wound-healing and histological studies, F2 was found to improve the wound-healing effect compared with the hydrogel without the drug, and the conventional product.

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Section: Introductionmentioning

confidence: 99%

An Investigation and Characterization on Alginate Hydogel Dressing Loaded with Metronidazole Prepared by Combined Inotropic Gelation and Freeze-Thawing Cycles for Controlled Release

Sarheed

Rasool²,

Abu‐Gharbieh

et al. 2014

AAPS PharmSciTech

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“…Six studies did not identify the type of secondary dressing used by researchers. Eight studies used semi‐occlusive film dressings as secondary dressings .…”

Section: Resultsmentioning

confidence: 99%

“…Within this evidence-based review, 16 studies assessed pain on dressing removal, whilst only 1 study 45 detailed the method of dressing removal. Eight studies 12,20,21,25,26,29,30,47 did not include an assessment of donor site wound pain on dressing removal as the dressings were left in situ on the wound bed until spontaneous separation of the dressing occurred.…”

Section: Dressing Removal and Pain Managementmentioning

confidence: 99%

An evidence‐based review of split‐thickness skin graft donor site dressings

Brown

Holloway

2018

International Wound Journal

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This evidence-based review aimed to identify and evaluate current existing evidence relating to the efficacy of dressing materials for spit-thickness skin graft donor site wounds in relation to promoting rapid healing and reducing patient pain. A comprehensive systematic search of the literature between 2006 and 2016 identified 35 publications that were included in the review. Based on the results of the review, it was found that moist wound-healing products have a clear advantage over non-moist products in the reduction of pain and increased healing rates. This review concluded that moist wound-healing products are more effective than non-moist wound-healing products in reducing pain and promoting healing in split-thickness skin graft donor site wounds. A recommendation based on this review is that further research examine the role of secondary dressing usage in donor site wound management, and the consideration of using more than one primary dressing product during the donor site wound-healing process should be undertaken.

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“…A systematic review of 75 articles describing over 50 different dressings in studies published before 2008 concluded that there is no clear evidence of the superiority of wet dressings over dry ones as had been previously published . Since then, multiple studies have compared different subsets of two or three dressings in randomized controlled trials, so it is still unclear whether one dressing is superior to all others . In general, the difficulty associated with covering donor sites consists in satisfactorily achieving exudate absorption to avoid maceration, without drying the wound to the point of having the dressing adhere to it.…”

Section: Discussionmentioning

confidence: 99%

“…In general, the difficulty associated with covering donor sites consists in satisfactorily achieving exudate absorption to avoid maceration, without drying the wound to the point of having the dressing adhere to it. Problems with leakage of blood and fluid are common, and patients often complain more about the donor site than the site treated with the graft due to pain, irritation, and the discomfort caused by bulky or leaking dressings . Better solutions are still needed for this application in order to manage the donor site with minimal dressing changes in order to reduce disruptions to the healing process.…”

Section: Discussionmentioning

confidence: 99%

In vivo methods to evaluate a new skin protectant for loss of skin integrity

Been¹,

Bernatchez²,

Conrad‐Vlasak³

et al. 2016

Wound Repair Regeneration

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A new skin protectant was developed for use on conditions involving partial-thickness skin loss such as severe incontinence-associated dermatitis. This new formulation is based on a cyanoacrylate chemistry designed to polymerize in situ and create a breathable film able to protect the skin surface from external irritants. This film provides an environment favorable for healing to occur beneath the film. To evaluate the characteristics of the novel chemistry, we devised a preclinical testing strategy comprising three different animal models. The data from all three models was considered collectively to create an overall assessment of effectiveness. A guinea pig model was used to evaluate the barrier efficacy of the new product in protecting intact skin from irritation. A porcine partial-thickness wound model was used to evaluate the efficacy of the product in helping control minor bleeding and exudate. A similar model was also used to assess the process of reepithelialization in the continued presence of an irritant. In the first model, untreated sites had 8.5 times more irritation than sites covered with the new product (p < 0.001). In the second model, a single application of the new product successfully attached to intact peri-wound skin and to denuded, weepy skin. It significantly reduced the amount of fluid weeping from the wounds (p 0.001) and continued to perform throughout a 96 hours experiment. In the third model, the percent of reepithelialization was significantly greater for the wounds covered with the new product than for the control wounds (p 5 0.003; on average, 18.3% greater, with a 95% confidence interval of 9.2% to 27.5%). These results suggest that the new skin protectant protects intact and denuded skin from irritants and provides an environment favorable to healing, offering promise for the management of various conditions involving loss of epidermis. Wound healing is a complex biological process with several steps involved to restore skin integrity (hemostasis, inflammation, granulation tissue formation, and remodel-ing). The biological events involved and how they can be modulated using current knowledge and technology have been recently reviewed by Wong et al. 1 The context of the wound impacts the sequence of events that will follow and the successful resolution of the wound. A variety of products are available to manage wounds. Dressings are typically used for acute (surgical or traumatic) and chronic wounds (recently reviewed by Sood et al. 2); however, severe skin damage such as that seen in incontinence-associated dermatitis (IAD) requires a different approach due to the location on the body and the necessity for frequent cleaning caused by incontinence episodes. In mild cases of IAD (skin is red and macerated but epidermis is still present), barrier films can be used. These products are applied as liquids, either in a spray formulation, a wipe, or a wand applicator, and polymerize to form a film in situ and protect the skin. In severe cases of IAD, however , the epidermis is breached...

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Management of Split-Thickness Skin Graft Donor Sites: A Randomized Controlled Trial of Calcium Alginate versus Polyurethane Film Dressing

Cited by 26 publications

References 28 publications

An Investigation and Characterization on Alginate Hydogel Dressing Loaded with Metronidazole Prepared by Combined Inotropic Gelation and Freeze-Thawing Cycles for Controlled Release

An Investigation and Characterization on Alginate Hydogel Dressing Loaded with Metronidazole Prepared by Combined Inotropic Gelation and Freeze-Thawing Cycles for Controlled Release

An evidence‐based review of split‐thickness skin graft donor site dressings

In vivo methods to evaluate a new skin protectant for loss of skin integrity

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