- Discussion:
-
determine required thickness for the STSG:
- since a thick STSG graft harvested from donor site w/ a thin dermal
thickness, may lead to a full thickness wound, as well as causing
hyperpigmentation of the transplanted STSG;
- thick donor sites: posterolateral aspect of trunk and thighs;
- thin donor sites: inner aspect of thighs, and +/- buttocks;
-
patient age:
- in infants and in elderly patients, only the thinnest STSG grafts
(less than 0.008 inch) will be tolerated;
- in children, attempt to keep grafts less than 0.010 inch;
- adults: 0.015 inch STSG is tolerated;
-
biology of donor site healing:
- dermis site itself is inactive and shows no evidence of regeneration
following STSG removal;
- epithelial cells from remains of pilosebaceous units (hair follicles &
sebaceous glands) and the sweat glands migrate across the surface
until they unite with one another;
- Choice of Donor Site Dressings:
- split thickness allografts have been shown to be detrimental as skin graft donor
site dressing as they produce a rejection reaction, which can lead to full
thickness wound rather than healed wound;
- consider initially appyling epinephrine soaked gauze or perhaps thrombin
soaked gauze (this may be expensive);
- at the end of the case apply an Op Site Dressing;
- some physicians will "pie crust" the Op Site Dressing and then apply
over this a thick guaze dressing inorder to allow egress of fluid;
-------------------------
Comparison of calcium sodium alginate (KALTOSTAT) and porcine xenograft
(E-Z DERM) in the healing of split-thickness skin graft donor sites.
A comparison of Zenoderm with DuoDERM E in the treatment of split skin
graft donor sites.
Comparing DuoDERM E with scarlet red in the treatment of split skin graft
donor sites.
Porcine dermal collagen as a wound dressing for skin donor sites and deep
partial skin thickness burns.
A comparative investigation of re-epithelialisation of split skin graft
³
donor areas after application of hydrocolloid and alginate dressings [see
A silicone gel sheet dressing containing an antimicrobial agent for split
³
thickness donor site wounds.
