References

Demirtas Y, Yagmur C, Soylemez F Management of split-thickness skin graft donor site: a prospective clinical trial for comparison of five different dressing materials. Burns. 2010; 36:(7)999-1005 https://doi.org/10.1016/j.burns.2009.05.017

Karlsson M, Lindgren M, Jarnhed-Andersson I, Tarpila E. Dressing the split-thickness skin graft donor site: a randomized clinical trial. Adv Skin Wound Care. 2014; 27:(1)20-25 https://doi.org/10.1097/01.ASW.0000437786.92529.22

Cohn SM, Lopez PP, Brown M Open surgical wounds: how does Aquacel compare with wet-to-dry gauze?. J Wound Care. 2004; 13:(1)10-12 https://doi.org/10.12968/jowc.2004.13.1.26556

Serebrakian TA, Pickrell BB, Varon ED Meta-analysis and systematic review of skin graft donor-site dressings with future guidelines. Plast Reconstr Surg Glob Open. 2018; 6:(9) https://doi.org/10.1097/gox.0000000000001928

Renner R, Erfurt-Berge C. Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life. Chronic Wound Care Management and Research. 2017; 4:143-151 https://doi.org/10.2147/CWCMR.S124917

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Voineskos SH, Ayeni OA, McKnight L, Thoma A. Systematic review of skin graft donor-site dressings. Plast Reconstr Surg. 2009; 124:(1)298-306 https://doi.org/10.1097/PRS.0b013e3181a8072f

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Wound dressing
Wound healing
Leg ulcers

Comparison between Aquacel and Aquacel Foam dressing on split-thickness skin graft donor site

01 December 2021
Practice

Abstract

Objective:

To compare the effectiveness of two commonly used moist dressings, Aquacel and Aquacel Foam (both ConvaTec Ltd., UK), in managing split-thickness skin graft (STSG) donor site wounds.

Method:

Patients undergoing STSG harvesting for reconstruction were eligible for this quasi-experimental study. After reconstruction surgery, the Aquacel (A) or Aquacel Foam (AF) dressings were applied on the donor site wound. The STSG donor site was assessed by two trained research nurses daily. Clinical outcomes including pain on dressing removal, use of intravenous analgesics, signs and symptoms of wound infection, incidence of exudate leakage and percentage healed were recorded in a standardised form. Cost of the dressing change was retrieved from the hospital billing system.

Results:

Of 50 patients recruited, 25 received dressing A and 25 received the AF dressing for their STSG donor site wound. The average pain score on dressing removal was significantly lower in the AF dressing group compared with the A dressing group (0.8±0.8 versus 3.1±1.5, respectively (p=0.04)). Regression analysis demonstrated that compared with dressing A, the AF dressing was associated with a lower average pain score (beta: –2.27, standard error: 0.33; p<0.001), lower likelihood of pro re nata (PRN) intravenous analgesic use (odds ratio (OR)=0.21, 95% confidence interval: 0.06–0.71; p=0.01) and lower likelihood of exudate leakage (OR=0.11, p=0.01). The differences in time to wound healing, infection and cost were not statistically significant between the two groups.

Conclusion:

In this study, the AF dressing demonstrated superior performance in pain response on dressing removal for STSG donor site wounds compared with dressing A. Large-scale randomised controlled trials should be conducted to confirm the findings.

Hydrofibre technology is a promising type of moist dressing used in split-thickness skin graft (STSG) donor sites.1,2,3 Aquacel and Aquacel Foam (both ConvaTec Ltd., UK) are two commonly used moist dressings in clinical practice.

STSG is a widely used reconstructive technique for various indications, including burn wounds, traumatic wounds, infection and hard-to-heal ulcers. This procedure involves the harvesting of a sheet of skin comprising the epidermis and varying thicknesses of dermis which, as a consequence, also involves the creation of a superficial donor site wound. Due to the nerve exposure in STSG donor sites, pain from post-harvest wound management dressing change is inevitable.1 Thus, determining the optimal dressing for STSG donor sites is critical, as high levels of pain at donor sites can result in a prolonged hospital stay, increased pain medication use, decreased mobility, and negatively influence the patient's quality of life (QoL).4,5

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donor site
hydrofibre
moist dressing
reconstruction surgery
skin graft
split-thickness skin graft
wound
wound care
wound dressing
wound healing