From the Guidelines
The most appropriate dressing for a split-thickness skin graft (STSG) to protect the graft is a non-adherent dressing, such as a silicone-based dressing, to prevent damage to the newly formed granulation tissue and promote graft take.
Key Considerations
- The goal of dressing a STSG is to promote a moist environment that fosters wound healing and graft take, while minimizing the risk of infection and damage to the graft 1.
- A non-adherent wound contact layer, such as a silicone-based dressing, should be used to prevent the growth of newly formed granulation tissue into the dressing, which can cause damage to the underlying tissue during dressing changes 1.
- Occlusive dressings, such as film or hydrogel dressings, can also be used to promote wound healing by maintaining a moist environment and protecting the graft from external trauma 1.
- There is no evidence to support the use of antibiotic or antibacterial dressings in clean wounds, as they do not improve wound healing or decrease infection rates 1.
Dressing Selection
- The choice of dressing should be guided by the specific needs of the patient and the wound, including the size and location of the graft, as well as the presence of any underlying medical conditions 1.
- Meshed split-skin grafts are a common technique used in wound closure, but the choice of dressing should be based on the individual patient's needs, rather than the specific grafting technique used 1.
From the Research
Dressing Options for Split-Thickness Skin Grafts
The choice of dressing for split-thickness skin grafts (STSG) is crucial for successful healing. Various types of dressings are available, including:
- Hydrogel dressings 2
- Alginate dressings 2, 3
- Hydrocolloid dressings 3
- Hydrofiber dressings 3
- Silicone foam dressings 3
- Polyurethane film dressings 3, 4, 5
- Petrolatum gauze (Xeroform) 3
Characteristics of Ideal Dressings
The ideal dressing for STSG donor sites should:
- Promote rapid reepithelialization 3, 4, 5
- Minimize pain and discomfort 3, 4, 5
- Reduce the risk of infection 3, 5
- Be easy to use and apply 3, 4
- Be cost-effective 3, 5
Comparison of Dressing Materials
Studies have compared the effectiveness of different dressing materials, including:
- Hydrogel dressings vs. alginate dressings: hydrogel dressings may increase time to wound healing 2
- Hydrogel dressings vs. hydrocolloid dressings: DuoDERM (hydrocolloid) elicited the greatest percent reepithelialization 3
- Polyurethane film dressings vs. other dressings: polyurethane film dressings were associated with rapid reepithelialization and minimal pain 4, 5
Recommendations
Based on the available evidence, the following dressings may be suitable for STSG donor sites: