Split-thickness skin graft donor site management: a randomized controlled trial comparing polyurethane with calcium alginate dressings

Abstract

Split-thickness skin grafting (SSG) is a common reconstructive technique for the treatment of patients with deep burns and other traumatic injuries. The management of the donor site after harvesting an SSG remains controversial because of a variety of dressings available for use. The aim of this randomized controlled trial was to compare the effectiveness of a polyurethane dressing, Allevyn鬠to a calcium alginate, KaltostatFrom August 2009 to April 2010, 36 patients were randomized to Allevyn頯r Kaltostator donor site management following split skin graft surgery. Pain intensity and adverse events were the primary outcomes assessed. Secondary outcome measures included time for wound healing, ease of application and removal and overall patient satisfaction. Time to first dressing change was earlier in those randomized to Allevyn頣ompared with Kaltostat5絠days versus 8籱 days, P = 0簱4). In patients randomized to Allevyn鬠excessive exudate lead to a significantly increased number of dressing changes before day 10 (14 days versus 7 days, P = 0簱8). The total number of dressing changes applied was also greater in those with Allevyn頣ompared with KaltstatP = 0簰7). There were no significant differences between the two treatment groups with respect to time to wound healing, level of pain intensity, length of stay, staff and patient satisfaction levels. This trial showed Allevyn頴o be associated with increase demands on nursing time, increased cost of dressing products, medical consumables and wastes. Kaltostatemains the dressing of choice for initial donor site dressing in this burns unit.