Case Series/Study
Several options exist for managing graft donor sites in patients who undergo split-thickness skin grafting. The standard of care in our institution is the application of oxidized, regenerated cellulose mixed with thrombin, placed directly on the wound bed post-harvest. However, we have noted that patients have moderate post-application drainage and discomfort, and reapplications, as well as dressing changes, are frequently required. We therefore aimed to evaluate if the application of a biocompatible, etherified carboxymethyl cellulose matrix (ECCM)* to a split thickness skin graft (STSG) donor site was equally as effective in promoting hemostasis and donor site healing as our standard therapeutic intervention.
Methods:
After harvesting the autologous donor site grafts, ECCM* was cut to size and placed immediately on the thigh wound instead of our routine application of oxidized regenerated cellulose (ORC) with thrombin. A transparent film dressing was placed overlying. At 96 hours post-application, the transparent film dressing was removed, and a nonadherent dressing was applied and secured with a transparent film dressing. All patients were discharged thereafter and followed up in our vascular clinic.
Results:
All patients had rapid cessation of bleeding at the time of the STSG harvest after applying ECCM*. All patients had very good control of their wounds with minimal drainage at 48 and 96 hours post-application. Re-application of ECCM* at 96 hours was not necessary in any of the patients. Granulation and reepithelialization was noted to be progressively faster in all patients who were treated with ECCM* compared to SOC at weekly follow ups. Additionally, in those patients who had undergone prior STSG harvests, ECCM* was noted to be much more comfortable than the previous regimen.
Discussion:
A single application of ECCM* is a cost-effective strategy for donor graft site management that reduces pain and drainage. Patients who had undergone prior STSG harvests noted that ECCM* was much more comfortable compared to the previous regimen.
The ECCM* product works very effectively and evaluating its use in the future as an adjunct to wound healing may be an interesting and worthwhile endeavor.
A similar component was previously presented at Innovations in Wound Healing (IWH) 2023.