The use of moist wound‐healing dressings in the management of split‐thickness skin graft donor sites: a systematic review

Abstract

The aim of this systematic review was to determine the best available evidence related to the post-harvest management of split-thickness skin graft (STSG) donor sites. Studies included in the review were those involving patients of any age examining interventions relating to the post-harvest management of STSG donors and were intra-individual or randomized controlled trials. All studies were checked for methodological quality, and data were extracted using a data extraction tool. Many studies were combined in meta-analysis. The present report concerns studies examining moist and non-moist wound-healing dressings. Broad comparisons of moist wound-healing dressings against traditional non-moist dressings favoured moist wound-healing approaches in terms of healing rates, pain and infection. In comparing dressings within and between moist wound-healing dressing groups, the lack of studies of sufficient quality prevented determining a 'best dressing' for STSG donors. Moist wound-healing products have distinct clinical advantages over non-moist products in the management of STSG donors. There is a strong case for further head-to-head studies comparing products within the moist wound-healing group.

Wound bed preparation: A novel approach using HydroTherapy

“…HydroTac provides a continuum of hydration that aids wound healing.  Faster wound healing (Winter, 1962;Dyson et al, 1988;Beam et al, 2008)  Promote epithelialisation rate (Winter, 1962;Eaglstein, 2001;Ågren et al, 2001;Varghese et al, 1986;Rubio, 1991;Madden et al, 1989;Wigger-Alberti et al, 2009)  Promote dermal/wound bed healing responses, e.g., cell proliferation, ECM synthesis (Svensjö et al, 2000;Dyson et al, 1992;Mosti, 2013;Korting et al, 2010;Chen et al, 1992;Leung et al, 2010;Field & Kerstein, 1994;Dowsett & Ayello, 2004;Katz et al, 1991)  ReducI can't es scarring (Atiyeh et al, 2003(Atiyeh et al, ,2004O'Shaughnessy et al, 2009;Mustoe & Gurjala, 2011;Tandara et al, 2007;Hoeksema et al, 2013)  Retention of growth factors at wound site (Svensjö et al, 2000;Hackl et al, 2014;Powers et al, 2013;Chen et al, 1992;Attinger et al, 2006;Vogt et al, 1995)  Lower wound infection rates (Kannon & Garret, 1995;Hutchinson & Lawrence, 1991;Lawrence, 1994)  Reduces pain perception (Wiechula, 2003;Metzger, 2004;Leaper et al, 2012;Coutts et al, 2008;Feldman, 1991;...…”

Quality Randomized Clinical Trials of Topical Diabetic Foot Ulcer Healing Agents

“…Moist gauze rarely keeps wounds moist more than 4 h 47 providing substandard care 48,49 associated with increased pain and infection rates and delayed healing in acute and chronic wounds. [50][51][52] Avoid bias by using appropriate blinded random allocation to treatments, with patients, caregivers, investigators, and evaluators all blinded to treatment groups 53 until the database is locked.…”

Occlusive Dressings and the Healing of Standardized Abrasions

“…Although more clinically relevant, using the measure of days to complete healing (when dressings can be removed without trauma and pain) introduces the health care provider's error and bias resulting from skill and experience in dressing removal. 2 The wounds inflicted in this study were partial thickness in depth and were healed by the progression of epithelium from the wound edges and reservoirs of epithelium. Some authors 12 have suggested that these wounds demonstrate minimal contraction and that area is not a relevant measure of healing.…”

“…However, this assessment is a more objective measure of healing. 2 The dressings in this study are designed to remain on the wound bed from 3 to 7 consecutive days in the absence of leakage or signs of infection. To lessen interruption of healing, I performed cleansing, digital imaging, and redressing of the wounds in a 20-to 30-minute window.…”