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Updated: Jul 10, 2025
Murine Full-thickness Skin Transplantation
Published on: January 2, 2017
The effects of topical mafenide acetate application on skin graft survival in bacterial contaminated wounds
M Baver Acaban1, Alper Sarı1, Hatice Oruç Demirbağ2
1Plastic, Reconstructive and Aesthetic Surgery Department of Mersin University Medical Faculty, Mersin, Turkey.
Background:
Infection related skin graft loss still remains as a common problem even with the use of systemic antibiotics. Mafenide acetate (Sulfamylon) is a topical antimicrobial agent with a wide spectrum of antimicrobial activity. Since mafenide acetate has the ability to penetrate the burn eschar, it was preferred in the treatment of infected full-thickness skin grafts. We investigated the effects of topical Mafenide acetate application on graft survival in an experimental model of contaminated wound beds in rats.
Materials And Methods:
Twenty-eight male Wistar albino rats were included in the study. A full-thickness skin graft (FTSG) was harvested from the back region and the wound bed was inoculated with Pseudomonas aeruginosa. The same FTSG was sutured in place. Rats were divided into 4 groups. In groups 1 and 2, wound care was performed with gauze and hydrofiber dressings respectively. In groups 3 and 4, Mafenide acetate soaked hydrofiber and Mafenide acetate soaked gauze dressings were used respectively. The dressings were closed for 4 days in all groups. The rats in groups 1 and 2 received dressing changes every day. The dressing of the rats in group 3 was changed once every two days. The dressing of the rats in group 4 was changed twice a day.
Results:
In groups 3 and 4, the graft survival rates decreased significantly from day 7 to day 14 in all groups. Histologically, detachment at the dermoepidermal junction, disorganization of collagen along with increased numbers of fibroblasts and a decrease in graft adhesion to the wound bed were determined in Mafenide acetate-treated groups.
Conclusion:
In rats treated with Mafenide acetate, graft survival was higher on day 7 and gradually decreased towards day 14. Application of a 2.5% solution of Mafenide acetate longer than 7 days on inoculated skin grafts in a rat model causes significant cytotoxicity and graft loss.
Insights
Topical Mafenide acetate showed initial graft survival but led to significant cytotoxicity and graft loss in rats by day 14. This study highlights the risks of prolonged use of Mafenide acetate on infected skin grafts.
Area of Science:
- Wound healing research
- Dermatology
- Surgical infection control
Background:
- Skin graft loss due to infection is a persistent clinical challenge, often inadequately addressed by systemic antibiotics.
- Mafenide acetate, a topical antimicrobial, penetrates burn eschar and is used for infected full-thickness skin grafts.
- This study evaluates topical Mafenide acetate's impact on graft survival in a rat model of contaminated wounds.
Purpose of the Study:
- To investigate the effects of topical Mafenide acetate on skin graft survival.
- To assess the efficacy and potential cytotoxicity of Mafenide acetate in infected wound beds.
Main Methods:
- Twenty-eight rats underwent full-thickness skin grafting with Pseudomonas aeruginosa inoculation.
- Four groups received different dressings: gauze, hydrofiber, Mafenide acetate-soaked hydrofiber, or Mafenide acetate-soaked gauze.
- Dressing change frequency varied across groups, with Mafenide acetate groups having less frequent changes.
Main Results:
- Graft survival rates significantly decreased from day 7 to day 14 in Mafenide acetate-treated groups.
- Histological analysis revealed dermoepidermal junction detachment and collagen disorganization in Mafenide acetate-treated grafts.
- Mafenide acetate application demonstrated cytotoxicity, leading to reduced graft adhesion and survival.
Conclusions:
- Topical Mafenide acetate application resulted in higher graft survival on day 7, but this decreased significantly by day 14.
- Prolonged use (over 7 days) of Mafenide acetate on infected skin grafts in this rat model induces significant cytotoxicity and graft loss.
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