Effects of Dressing Materials on Donor Site Morbidity: A Comparative Study at a Tertiary Hospital in Kenya

Skin graft donor wounds should heal with rapid epithelialization resulting in good aesthetic and minimal donor site morbidity. Several dressing materials are now available for the dressing of the donor sites. Few studies have, however, been done to compare the efficacy of these dressing materials.This study compared the effectiveness of paraffin gauze, hydrocolloid, antimicrobial biguanide foam, and silver hydrofiber dressings on donor site wounds at a tertiary hospital in Kenya.Patients who underwent split-thickness skin graft were recruited and randomized into 4 arms. The donor site wound was dressed with either of the 4 dressing material mentioned earlier. The patient and observers were blinded. Outcome variables that were assessed were donor site pain on days 1, 3, and 10, and infection and percentage epithelialization on day 10.Wounds dressed with hydrocolloids were the least painful on all the 3 postoperative days assessed. Those dressed with paraffin gauze were the most painful on day 1, whereas those with antimicrobial foam were the most painful on the 10th day. The mean (SD) percentage epithelialization of the wounds on the 10th day were as follows; hydrocolloids, 92.2% (20.9%); silver hydrofiber, 91.4% (18.8%); paraffin gauze, 73.4% (24.9%); and antimicrobial biguanide foam, 11.0% (10.3%). Paraffin gauze dressed wounds were the most infected at 22%.In conclusion, all the 4 dressing materials had different scores among the factors assessed. Hydrocolloids dressings and silver hydrofiber dressing would, however, be the preferred dressing materials for the donor site based on these study findings as reflected by the high epithelialization low infection rates and less pain.