Abstract
Although the recipient site in burn wounds is dressed with universally accepted materials, the ideal management of split-thickness skin donor sites remains controversial. The aim of our study is to compare two methods of wound dressing in donor sites of split-thickness skin graft in patients undergoing burn wound reconstructive surgery. Forty-two consecutive patients with second- and third-degree burns with a total body surface area between 20 and 40 % were enrolled in this randomized clinical trial conducted in Motahari Burn Hospital in Tehran, Iran. In each patient, two anatomic areas with similar features were randomly selected as intervention and control donor sites. The intervention site was dressed with amniotic membrane, whereas the control site was treated with Vaseline-impregnated gauze. Wounds were examined daily by expert surgeons to measure the clinical outcomes including duration of healing, severity of pain, and infection rate. The mean ± SD age of patients was 31.17 ± 13.72 years; furthermore, burn percentage had a mean ± SD of 31.19 ± 10.56. The mean ± SD of patients' cooperation score was 1.6 ± 0.79 in the intervention group compared with 2.93 ± 0.71 in the control group, revealing a statistically significant difference (P < 0.05). Duration of wound healing was significantly shorter (P < 0.05) in the intervention group (17.61 ± 2.56 days) compared with the control group (21.16 ± 3.45 days). However, there was no significant difference in terms of wound infection rate between donor sites in the control and intervention groups (P > 0.05). Amniotic membrane as an alternative for dressing of skin graft donor sites provides significant benefits by increasing patients' comfort via diminishing the number of dressing changes and facilitating the process of wound healing.
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Demirtas Y, Yagmur C, Soylemez F, Ozturk N, Demir A (2010) Management of split-thickness skin graft donor site: a prospective clinical trial for comparison of five different dressing materials. Burns 36(7):999–1005
Higgins L, Wasiak J, Spinks A, Cleland H (2012) Split-thickness skin graft donor site management: a randomized controlled trial comparing polyurethane with calcium alginate dressings. Int Wound J 9(2):126–131
Rakel BA, Bermel MA, Abbott LI, Baumler SK, Burger MR, Dawson CJ et al (1998) Split-thickness skin graft donor site care: a quantitative synthesis of the research. Appl Nurs Res 11(4):174–182
Cadier M, Clarke J (1996) Dermasorb versus Jelonet in patients with burns skin graft donor sites. J Burn Care Rehabil 17:246–251
Argirova M, Hadjiski O, Victorova A (2007) Acticoat versus Allevyn as a split-thickness skin graft donor-site dressing: a prospective comparative study. Ann Plast Surg 59:415–422
Uysal AC, Alagoz MS, Orbay H, Sensoz O (2006) An alternative dressing material for the split-thickness skin graft donor site: oxidized regenerated cellulose. Ann Plast Surg 57:60–64
Muangman P, Nitimonton S, Aramwit P (2011) Comparative clinical study of Bactigras and Telfa AMD for skin graft donor-site dressing. Int J Mol Sci 12(8):5031–5038
Fraser J, Cuttle L, Kempf M, Phillips G, Hayes M, Kimble R (2009) A randomised controlled trial of amniotic membrane in the treatment of a standardised burn injury in the merino lamb. Burns 35(7):998–1003
Coudray S, Lucas C, Bever H, Cynober L (2000) Ornithine alpha-ketoglutarate improves wound healing in severe burn patients: a prospective randomized double-blind trial versus isonitrogenous controls. Crit Care Med 28(6):1772–1776
Vogt P, Andree C, Breuing K, Liu P, Slama J, Helo G et al (1995) Dry, moist, and wet skin wound repair. Ann Plast Surg 34:493–499
Kesting MR, Wolff KD, Hohlweg-Majert B, Steinstraesser L (2008) The role of allogenic amniotic membrane in burn treatment. J Burn Care Res 29(6):907–916
Borland M, Bergesio R, Pasco E, Turner S, Woodger S (2005) Intranasal fentanyl is an equivalent analgesic in pediatric patients for dressing changes: a randomized double blind crossover study. Burns 31:831–387
Davis J (1910) Skin transplantation. With re-view of 550 cases at the Johns Hopkin's Hospital. JHH Report 15:307
Sabella N (1913) Use of the fetal membranes in skin grafting. Med Ret NY 83:478
Barnett A, Berkowitz RL, Mills R, Vistnes LM (1983) Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites. Am J Surg 145(3):379–381
Barnea Y, Amir A, Leshem D, Zaretski A, Weiss J, Shafir R et al (2004) Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment. Ann Plast Surg 53:132–136
Birdsell DC, Hein KS, Lindsay RL (1979) The theoretically ideal donor site dressing. Ann Plast Surg 2(6):535–537
Innes ME, Umraw N, Fish JS, Gomez M, Cartotto RC (2001) The use of silver coated dressings on donor site wounds: a prospective, controlled matched pair study. Burns 27(6):621–627
Disa JJ, Alizadeh K, Smith JW, Hu Q, Cordeiro PG (2001) Evaluation of a combined calcium sodium alginate and bio-occlusive membrane dressing in the management of split-thickness skin graft donor sites. Ann Plast Surg 46(4):405–408
Alvarez O, Mertz P, Eaglestein W (1983) The effect of occlusive dressing on collagen synthesis and reepithelialization in superficial wounds. J Surg Res 35:142–148
Kilinc H, Sensoz O, Ozdemir R, Unlü R, Baran C (2001) Which dressing for split-thickness skin graft donor sites? Ann Plast Surg 46:409–414
Hosnuter M, Tosun Z, Savacı N (1999) Oklu ¨ zif pansumanlar ve klinik deneyimlerimiz. Tu¨rk Plast Cer Derg 7:23–27
Ozkan A, Tosun Z, Senturk S, Tuncer S, Savaci N (2005) Greft dono ¨ r alanı bakımında hidrojel kullanımı. Tu¨rk Plast Est Cer Derg 13:28–31
Wang TH, Ma H, Yeh FL, Lin JT, Shen BH (2010) The use of “composite dressing” for covering split-thickness skin graft donor sites. Burns 36(2):252–255
Melandri D, De Angelis A, Orioli R, Ponzielli G, Lualdi P, Giarratana N et al (2006) Use of a new hemicellulose dressing (Veloderm) for the treatment of split-thickness skin graft donor sites. A within-patient controlled study. Burns 32(8):964–972
Adly OA, Moghazy AM, Abbas AH, Ellabban AM, Ali OS, Mohamed BA (2010) Assessment of amniotic and polyurethane membrane dressings in the treatment of burns. Burns 36(5):703–710
Branski L, Herndon D, Celis M, Norbury W, Masters O, Jeschke M (2008) Amnion in the treatment of pediatric partial- thickness facial burns. Burns 34(3):393–399
Kuitian T, Obendorf S (2007) Development of an antimicrobial microporous polyurethane membrane. J Membr Sci 289(1/2):199–209
Maral T, Borman H, Arslan H, Demirhan B, Akinbingol G, Haberal M (1999) Effectiveness of human amnion preserved long-term in glycerol as a temporary biological dressing. Burns 25(7):625–635
Atanassov W, Mazgalova J, Todorov R, Stereva K, Trencheva W (1994) Use of amniotic membrane as biologic dressing contemporary treatment of burns. Ann Med Burn Club 7:202–205
Lorusso R, Geraci V, Masellis M (1989) The treatment of superficial burns with biological and synthetic material: frozen amnion and biobrane. Ann Med Club 2:79–48
Anatassov N, Nessa A (2002) Role of human amniotic membrane in the treatment of burn wounds. Ann Burns Fire Disasters 15(4):25–30
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Salehi, S.H., As’adi, K., Mousavi, S.J. et al. Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients. Indian J Surg 77 (Suppl 2), 427–431 (2015). https://doi.org/10.1007/s12262-013-0864-x
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DOI: https://doi.org/10.1007/s12262-013-0864-x