Polylactic Acid Membrane Improves Outcome of Split-Thickness Skin Graft Donor Sites: A Prospective, Comparative, Randomized Study

Moellhoff, Nicholas; Lettner, Maria; Frank, Konstantin; Giunta, Riccardo E. und Ehrl, Denis (2022): Polylactic Acid Membrane Improves Outcome of Split-Thickness Skin Graft Donor Sites: A Prospective, Comparative, Randomized Study. In: Plastic and Reconstructive Surgery, Bd. 150, Nr. 5: S. 1104-1113

Abstract

Background: Polyurethane film dressings are commonly applied for coverage of split-thickness skin graft donor sites, although previous studies have suggested reduced morbidity using a polylactic acid membrane. To further investigate the optimal treatment approach, the authors compared outcomes of donor sites in patients receiving either polylactic acid membrane or polyurethane film. Methods: This randomized clinical trial allocated patients requiring split-thickness skin grafting to receive either polylactic acid membrane or polyurethane film at the donor site. The primary endpoint was difference in donor-site scar appearance between groups 3 months postoperatively, using the Vancouver Scar Scale. Secondary endpoints included pain, number of and time required for wound dressing changes, and costs related to the wound dressing. Results: Thirty patients were allocated to each group. The median Vancouver Scar Scale score was lower for patients receiving polylactic acid membrane [polyurethane film, 3 (interquartile range, 2 to 4);polylactic acid membrane, 2 (interquartile range, 1 to 3);p = 0.049]. Pain during change of wound dressing (polyurethane film, 2.0 +/- 0.2;polylactic acid membrane, 0.5 +/- 0.2;p < 0.001) and mobilization (polyurethane film, 0.8 +/- 0.2;polylactic acid membrane, 0.3 +/- 0.1;p = 0.032) were reduced in the polylactic acid membrane group. Patients with polylactic acid membrane required fewer dressing changes per day of hospital stay (polyurethane film, 0.44 +/- 0.06;polylactic acid membrane, 0.28 +/- 0.02;p = 0.015). Mean time for wound dressing changes per patient was higher in the polyurethane film group (polyurethane film, 74.50 +/- 5.72 minutes;polylactic acid membrane, 21.43 +/- 2.61 minutes;p < 0.001). Costs were higher in the polylactic acid membrane group (polyurethane film, (sic)67.83 +/- (sic)5.56;polylactic acid membrane, (sic)162.79 +/- (sic)21.76;p < 0.001). Conclusion: Polylactic acid membrane improves outcome of split-thickness skin grafting donor sites;however, higher treatment costs must be taken into consideration.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0032-1052
• Sprache: Englisch