Varon David E, Smith Jessica D, Bharadia Deepak R, Shafique Neha, Sakthivel Dharaniya, Halvorson Eric G, Nuutila Kristo, Sinha Indranil
Research Assistant; Division of Plastic Surgery, Brigham and Women's Hospital, Boston, US., Harvard Medical School, Boston, US.
Plastic Surgery Resident UCSF; Division of Plastic and Reconstructive Surgery, University of California, San Francisco, US.
J Wound Care. 2018 Jul 1;27(Sup7):S12-S18. doi: 10.12968/jowc.2018.27.Sup7.S12.
Split-thickness skin graft (STSG) donor site dressings can play an integral role in reducing donor site morbidity. This study tested a novel, chitosan-based wound dressing, Opticell Ag, as an STSG donor site dressing for wounds <10% total body surface area (TBSA).
Between January and December 2016, the chitosan-based dressing was placed on participating patients' donor sites immediately following graft harvest and covered with a transparent occlusive dressing. Pain was evaluated on postoperative day one, before dressing change between days 5-7, and before and after dressing removal between days 10-14 using the Visual Analog Scale (VAS). The extent of re-epithelialisation was determined between day 10-14 and at one month, and healing quality was also evaluated at one month post-operatively using the Vancouver Scar Scale (VSS).
A total of 19 patients were recruited, of which 16 completed the study. Patients experienced mild-to-moderate pain in their donor sites when the chitosan-based dressing was used. Pain decreased significantly between postoperative day one and days 10-14, as well as between days 5-7 and 10-14. The mean percentage of re-epithelialisation on days 10-14 was 92% and by one month was 99%. The mean VSS at one month was 3.2±1.4. There were no statistically significant differences between patients' re-epithelialisation rates or VSS scores. There were unplanned dressing changes in four patients. No donor site infections or other adverse events were identified.
The chitosan-based dressing tested in this study is safe, effective, and associated with reasonable pain control and acceptable healing quality. The results suggest that it is a promising STSG donor site dressing.
分层皮片移植（STSG）供皮区敷料在降低供皮区发病率方面可发挥重要作用。本研究测试了一种新型的基于壳聚糖的伤口敷料Opticell Ag，作为用于体表面积（TBSA）小于10%伤口的STSG供皮区敷料。
在2016年1月至12月期间，将基于壳聚糖的敷料在取皮后立即放置在参与研究患者的供皮区，并覆盖透明封闭敷料。使用视觉模拟量表（VAS）在术后第1天、第5 - 7天换药前以及第10 - 14天换药前后评估疼痛情况。在第10 - 14天和1个月时确定上皮再形成的程度，并在术后1个月使用温哥华瘢痕量表（VSS）评估愈合质量。
共招募了19名患者，其中16名完成了研究。使用基于壳聚糖的敷料时，患者供皮区经历轻至中度疼痛。疼痛在术后第1天至第10 - 14天之间以及第5 - 7天至10 - 14天之间显著降低。第10 - 14天上皮再形成的平均百分比为92%，到1个月时为99%。1个月时的平均VSS为3.2±1.4。患者的上皮再形成率或VSS评分之间无统计学显著差异。4名患者出现非计划的换药情况。未发现供皮区感染或其他不良事件。
本研究中测试的基于壳聚糖的敷料安全、有效，且与合理的疼痛控制和可接受的愈合质量相关。结果表明它是一种有前景的STSG供皮区敷料。
