Nanofiber Matrix Dressing for Split-Thickness Skin Graft Donor Sites: A Randomized Comparative Clinical Study

Donor-site morbidity after split-thickness skin graft (STSG) harvest remains a significant clinical concern, with pain representing one of the most burdensome early postoperative symptoms. Electrospun nanofiber matrices have emerged as a promising wound management strategy, yet clinical evidence supporting their use in STSG donor sites remains limited. We evaluated the clinical performance of a nanofiber matrix for donor-site management after STSG harvest.

This single-center randomized comparative study enrolled 40 adult patients undergoing STSG harvest into either the nanofiber matrix group (n=20) or the conventional dressing group with chlorhexidine paraffin gauze and povidone-iodine gauze (n=20). Pain intensity was measured on a 0-10 scale on postoperative days 1, 2, 5, and 14. Secondary outcomes included donor-site healing time, pruritus during healing, late scar hyperpigmentation, scar elevation, late pruritus, and local or systemic signs of infection.

Compared with conventional management, the nanofiber matrix significantly reduced donor-site pain on postoperative day 1 (p<0.001), day 2 (p<0.001), and day 5 (p=0.015), but not on day 14 (p=0.36). The nanofiber group also healed faster than the control group (15.05±2.34 vs 18.15±4.38 days; p=0.045). Pruritus during healing did not differ significantly between groups (p=0.97). At late follow-up, we found no significant between-group differences in hyperpigmentation (p=0.11), scar elevation (p=0.051), or late pruritus (p=1.0). Mild exudate occurred in 3 patients in the nanofiber group, without a significant between-group difference (p=0.12), and we identified no other infection-related complications.

Nanofiber matrix dressing reduced early postoperative pain and shortened healing time at STSG donor sites compared with conventional dressing, while late scar outcomes and short-term safety remained comparable between groups. These findings support the potential of nanofiber-based donor-site management as a clinically relevant translational application of electrospinning technology.