A comparative clinical study of collagen and paraffin gauze dressing on skin donor site

Abstract

Background: Split skin grafting (SSG) is a commonly performed plastic surgical procedure. It is done to cover wounds, defects from excision of cutaneous lesions, donor sites of fascio-cutaneous flaps. The harvest of a split thickness skin graft causes a partial thickness injury. Complete re-epithelialization occurs in 10-14 days, although the rate may be affected by the local wound environment. However, tissue desiccation and infection can convert a partial thickness injury to a full thickness loss. Aims and Objectives: The purpose of the study was to determine the best method of dressing the donor site split-thickness graft between conventional paraffin gauze dressing and collagen-based dressings with respect to the rate of healing, pain, secretion, infection, and cost. Settings and Design A hospital based Non-Randomized control trial was conducted in a tertiary hospital setup in Manipur, India, for a period of 2 years. This study was done on 60 patients who underwent split skin graft procedure. Materials and Methods: The selected sample will be divided into two groups. The donor site dressing was done in two different ways. One was dressed with collagen sheet and the other with paraffin gauze dressing. The two groups were compared on the basis of post-operative pain, complication, and healing. Statistical analysis Statistical analysis was done by using IBM SPSS Version 21 for windows. Descriptive statistics such as mean, proportion, percentage were used to present the result. Chi square test was used to see the association of proportions. Student's t- test and repeated ANOVA were used for the continuous variables. P-value <0.05 was taken as significant. Results: A total of 60 patients were included in this study as per the estimated sample size. The Case group i.e., the patients for whom the STSG donor site were dressed by Collagen dressing and the Control group i.e., the patients for whom paraffin gauze dressings were used. Patients with collagen dressings are found to have only minimal to moderate pain in the entire postoperative period. In these patient's analgesic requirement is reduced, and early mobilization can be done. This is the major advantage of using collagen as a donor site dressing. We found that collagen slightly increases epithelization, which will reduce the chance of infection saving time and resources for the hospital staff and minimizing discomfort for the patient. Conclusion: In this study it was found that dressing the donor site for split-thickness graft with collagen-based dressings gave better results with respect to the rate of healing and post-operative pain scores than conventional paraffin gauze dressing.