Abstract | March 2, 2021

The Ideal Donor Site Dressing: A Comparison of the Chitosan Based Gelling Dressing to Traditional Dressings

Presenting Author: Nkemjika Uke, MS3, Timothy J Harner, Texas Tech Health Science Center, School of Medicine, Lubbock, TX

Co-Authors: Simran Singh, MBA, MS4,TTUHSC, Lubbock, TX, Grant Sorenson, PhD, MS4,TTUHSC, Lubbock, TX, Ebrahim Payberah, MS3, TTUHSC, Lubbock, TX, Ilina Terziyski, MS3, TUHSC, Lubbock, TX, & John Griswold, MD Medical Director, Timothy J Harnar Burn Center TTUHSC, Lubbock, TX

Learning Objectives

  1. Identify the properties of an Ideal donor site dressing;
  2. Evaluate the properties of CBGD as compared to traditional dressings.

Background: Management of a donor site after skin grafting requires the proper donor site dressing for optimum healing. Advancements in medical technologies have led to an abundance of dressing types yet the ideal donor site dressing has not been developed. The ideal donor site dressing speeds healing, prevents desiccation, allows gas exchange, possesses antimicrobial activity, is hemostatic, easy to care for, cost-effective, and minimally painful for the patient. Chitosan-based gelling dressing (CBGD, Opticell Gelling Fiber Wound Dressing, Medline Industries, Inc) seeks to address many of these categories. The primary objective of this study was to evaluate the properties of CBGD as compared to traditional dressings.

Methods: We reviewed patients from the Burn Registry who underwent split-thickness skin grafting and had CBGD used on their donor site. We collected data on the following variables: donor site infections, healing rate, excess bleeding, length of stay (LOS), and cost We obtained data on traditional dressings through literature search which included: Xeroform, Scarlet Red, Opsite, cadaveric skin, and pigskin.

Results: A total of 114 patient charts were reviewed that were found to use CBGD as their primary donor site dressing with an average LOS of 19 days. We found an infection rate of 7%, an excess bleeding rate of 2.7%, and a cost of $0.04/ cm2 of dressing.

Conclusion: Healing rates (days) reported in the literature were: Scarlet Red 10.25, CBGD 10.46, Opsite 11.48, Xeroform 11.52, xenograft 15.2 ^3, and allograft 19 ^3. Infection rates reported for Scarlet Red ranged from 0% to 9.5% ^(1,4), Opsite at 40% ^1, and Xeroform at 0% ^2 compared to CBGD which had a low rate of 7%. CBGD was found to be more cost-effective than Xeroform, Opsite, and xenograft. Overall, CBGD speed donor site healing, has hemostatic control, and a low infection rate with very minimal complications. These results support the possibility of CBGD being a candidate for the ideal donor site dressing.

References and Resources

  1. Dhanraj P. A Clinical Study Comparing Helicoll with Scarlet Red and OpSite in the Treatment of Split Thickness Skin Graft Donor Sites-A Randomized Controlled Trial. Indian J Surg. 2015 Dec;77(Suppl 2):385-92. doi: 10.1007/s12262-013- 0850-3. Epub 2013 Feb 21. PubMed PMID: 26730031; PubMed Central PMCID: PMC4692922.
  2. Feldman, D. L., Rogers, A., & Karpinski, K. (1991). A prospective trial comparing Biobrane, Duoderm and xeroform for skin graft donor sites. Surg Gynecol Obstet., 173(1), 1–5.
  3. Hermans, M. H. (2014). Porcine xenografts vs. (cryopreserved) allografts in the management of partial thickness burns: Is there a clinical difference? Burns, 40(3), 408-415. doi:10.1016/j.burns.2013.08.020
  4. Prasad JK, Feller I, Thomson PD. A prospective controlled trial of Biobrane versus scarlet red on skin graft donor areas. J Burn Care Rehabil. 1987 Sep-Oct;8(5):384-6. doi: 10.1097/00004630-198709000-00009. PubMed PMID: 3312216.
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