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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.