Accelerating Healing of Split Thickness Skin Graft Donor Sites
Platelet-derived growth factor (PDGF) is the most effective agent for accelerating healing of donor sites for split thickness skin grafts, based on the most recent and highest quality evidence. 1
Evidence-Based Comparison of Growth Factors
Platelet-Derived Growth Factor (PDGF)
- In a 2022 randomized clinical trial, PDGF demonstrated superior efficacy with 55% of donor sites showing complete epithelialization by day 8, compared to only 20% in standard care sites 1
- PDGF not only accelerated healing but also provided better pain control and improved scar quality outcomes 1
- The ability of rhPDGF-BB to induce chemotaxis and mitogenesis of host cells, accelerate angiogenesis, and enhance wound healing makes it particularly effective for soft tissue healing 2
Epidermal Growth Factor (EGF)
- While EGF has shown some promise in accelerating epidermal regeneration, studies have shown conflicting results 2
- A 1989 study demonstrated that EGF decreased average healing time by approximately 1-1.5 days in donor sites 3, but more recent guidelines note that no clear outcomes in terms of healing have been consistently demonstrated 2
Recombinant Human Growth Hormone
- Limited evidence exists regarding the efficacy of recombinant human growth hormone specifically for STSG donor site healing
- Current guidelines do not recommend it as a first-line treatment for wound healing acceleration 2
Transforming Growth Factor-β
- Current evidence does not strongly support the use of TGF-β for accelerating donor site healing 2
- Studies of basic fibroblast growth factor do not support its routine use in clinical practice 2
Best Practices for Donor Site Care
Dressing Selection
- Adequate dressings should cover the donor site until it is fully epithelialized 4
- Atraumatic and absorptive dressings are important for donor site management 2
Monitoring and Complications
- Donor sites require monitoring for signs of infection or delayed healing 4
- Patients with comorbidities may experience delayed donor site healing 4
Alternative Approaches
- For high-risk patients, "back grafting" (applying a meshed split-thickness skin graft to the donor site) may be considered to convert an open wound to a covered wound 5
- Negative pressure wound therapy can enhance healing in challenging cases 4
Conclusion
When considering options to accelerate healing of split thickness skin graft donor sites, platelet-derived growth factor demonstrates the strongest and most recent evidence for efficacy. It not only accelerates epithelialization but also improves pain control and scar quality outcomes. Other growth factors like EGF have shown some promise but with less consistent results in clinical trials.