STSG Donor Site

- 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 in order 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 donor areas after application of hydrocolloid and alginate dressings 

A silicone gel sheet dressing containing an antimicrobial agent for split  thickness donor site wounds.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 11:14 am