Dressing the Split-Thickness Skin Graft Donor Site: A Randomized Clinical Trial

OBJECTIVE: The primary objective of this study was to compare Aquacel (ConvaTec, Skillman, New Jersey), Allevyn (Smith & Nephew, St Petersburg, Florida), and Mediskin I (Molnlycke, Health Care AB, Gothenburg, Sweden) in the treatment of split-thickness skin graft donor sites. DESIGN: This study was performed as a prospective randomized, 3-arm, clinical study. SETTING: A clinical study performed at a hand and plastic surgery department with burn unit. PARTICIPANTS: The study included 67 adults with a total of 73 donor sites, which were on the thigh, not reharvested, and ranged between 30- and 400-cm(2) area. INTERVENTIONS: Subjects were randomly assigned to treatment with Aquacel, Allevyn, or Mediskin I. MAIN OUTCOME MEASURES: The donor site was assessed on postoperative days 3, 14, and 21 for healing, infection, pain, impact on everyday life, ease of use, and cost. MAIN RESULTS: The obtained results demonstrate significantly faster re-epithelialization for patients treated with Aquacel or Mediskin I compared with Allevyn. Regarding infections, there were no significant differences between the groups. Patients wearing Aquacel experienced significantly less pain changing the dressing and less impact on everyday life than the patients wearing Allevyn. Aquacel was shown to be significantly easier for the caregiver to use than Allevyn and Mediskin I. There is a significant difference in cost of treatment between the dressings, whereas Mediskin I is the most expensive. CONCLUSION: The authors' results support the use of Aquacel in the treatment of split-thickness skin graft donor sites. Aquacel has a low cost per unit, is user friendly, gives short healing time, and minimizes patient discomfort.