Evaluating Oxidized Regenerated Cellulose/Collagen Dressing Use Over Split-Thickness Skin Graft Donor Sites: A 5 Patient Case Series

Split-thickness skin graft (STSG) procedures create a secondary wound at the donor site that requires wound care. Our institution did not have a standard of care for donor site wounds. We evaluated the use of oxidized regenerated cellulose (ORC)/collagen dressings over STSG donor sites to standardize our institutional donor site treatment plan, improve patient comfort, and promote donor site wound healing. Five patients were included in this evaluation. Following the graft harvesting, donor sites received either mesh gauze impregnated with bismuth and petrolatum and occlusive secondary dressing (n=1), transparent occlusive dressing (n=1), or ORC/collagen dressings with a hydropolymer dressing and semi-occlusive dressing (n=3). Donor site epithelialization, patient-reported pain at dressing changes, and levels of exudate were assessed. STSGs were placed following skin excision (n=1), excisional debridement (n=2), burn contracture excision (n=1), or mastectomy (n=1). Minimal donor site epithelialization (~2%) was noted in the 2 control patients after dressing removal (5-7 days post procedure). Excess exudate was noted, requiring a secondary dressing change. Moderate pain during dressing changes (4/10 and 5/10) was reported in the control patients. Donor site epithelialization of 90% and 98% was noted in 2 patients receiving ORC/collagen dressings after dressing removal (5-7 days post procedure). The remaining ORC/collagen dressing patient showed 98% epithelialization 11 days post skin graft harvest. Minimal to no pain was reported during dressing changes in all 3 ORC/collagen dressing patients (0/10 to 1/10). Minimal exudate was noted under secondary dressings. Use of ORC/collagen dressings over STSG donor sites in these patients showed improved rates of donor site epithelialization, reduced pain at dressing changes, and decreased levels of exudate under secondary dressings compared to the two control dressings. These results led to the implementation of ORC/collagen dressings with hydropolymer dressing and semi-occlusive secondary dressings as our standardized treatment for donor sites.