Statement of Clinical Problem: Donor site care and dressing changes often cause discomfort for the patient and create issues related to healing. Using evidence-based practice, healing time and complications can be decreased, and discomfort lessened for the patient.

Description of past management: At our organization, standard of care for donor site dressing changes was Xeroformâ (iodine impregnated petroleum gauze) applied directly to the donor site in the operating room, along with heat lamp therapy. Dressing changes began several days post-op and consisted of traumatic removal of the gauze with intense pain and bleeding, disrupting healing and new cell growth. There was often confusion by nurses as to the best procedure, as they relied solely on the written physician order that was usually vague and incomplete.

Current Clinical Approach: The involvement of the CWOCNs included review of evidence-based practice and mentoring of the physicians. After utilizing the antimicrobial hydrofiber dressing with silver on several patients resulting in positive outcomes, the physicians were convinced of the effectiveness of this dressing for donor site care. Eventually, the Donor Site Care Orders was formally created, increasing nurse satisfaction related to improved communication and continuity of care.

Patient Outcomes: By replacing the dressing every 3 days, a moist healing environment is created which controls the wound bacteria and supports the body's healing process. This dressing not only reduces the risk of infection, but also results in decreased pain with each dressing change, and decreased healing time.

Conclusions: Donor site healing is enhanced with the use of an antimicrobial hydrofiber dressing with silver. By using evidence-based practice along with collaborative effort, quality of care to our patients was dramatically improved.