- 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
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.