Recent progress in polysaccharide and polypeptide based modern moisture-retentive wound dressings.

Wounds were considered as defects in the tissues of the human skin and wound healing is said to be a tedious process as there are possibilities of infection or inflammation due to microorganisms. Modern moisture-retentive wound dressing (MMRWD) is opening a new window toward wound therapy. It comprises different types of wound dressing that has classified based on their functionality. Selective polysaccharide-polypeptide fiber composite materials such as hydrogels, hydrocolloids, hydro fibers, transparent-film dressing, and alginate dressing are discussed in this review as a type of MMRWD. The highlight of this polysaccharide and polypeptide based MMRWD is that it supports and enhances the healing of different types of wounds by moisture absorption thus preventing infection. This study has given enlightenment on the application of selected polysaccharide and polypeptide based MMRWD that enhances wound healing actions still it has been observed that the composite wound healing dressing is more effective than the single one. The nano-sized materials (synthetic nano drugs and phyto drugs) were found to increase the efficiency of healing action while coated in the wound dressing material. Future research is required to find out more possibilities of the different composite types of wound dressing in the healing action.

Semi-occlusive dressing versus surgery in fingertip injuries: A randomized controlled trial.

OBJECTIVES: No gold-standard treatment has been established for the management of distal digital amputation in Ishikawa zones II and III. The objective of this study was to compare the results of management of fingertip amputation by semi-occlusive dressing versus surgery. The principal hypothesis was that a semi-occlusive dressing results in better recovery of sensory function than a digital flap. METHODS: We conducted a prospective, randomized, multicenter study of 44 patients: 23 managed conservatively with semi-occlusive dressing, and 21 surgically with digital flap. RESULTS: Mean follow-up was 12 months. Mean healing time was 4.9 weeks in the semi-occlusive dressing group and 3.6 weeks in the surgery group. There was no significant difference between groups for sensory recovery of fine touch (p = 0.198) or 2-point discrimination (p = 0.961). No infections were reported in either group. Hook-nail deformity was more frequent in the semi-occlusive dressing group, particularly in case of amputation in zone III. CONCLUSIONS: Semi-occlusive dressing enabled satisfactory healing and sensitivity recovery without increasing the risk of infection. However, in zone III amputation, we advocate surgical treatment with a digital flap, due to poor trophicity and the frequency of hook-nail deformity seen with conservative management. LEVEL OF EVIDENCE: II.

[Secondary wound closure with a new transparent negative pressure dressing]. / Sekundärer Wundverschluss mit einem neuen transparenten Unterdruckverband.

Secondarily healing surgical wounds can be treated with negative pressure dressings. Dressing changes can be painful due to the strong adherence of the polyurethane foam placed in the wound. After debridement and conditioning of the wound bed, secondary surgical wound closure with a surgical suture can be performed. Cutaneous negative pressure treatment is used preventively after primary surgical suturing. Descriptions for secondary wound closure without a surgical suture are not known to date. The preparation and handling of an innovative transparent dressing for the cutaneous application of negative pressure treatment is demonstrated. The dressing assembly consists of a transparent drainage film and a transparent occlusion film. Negative pressure is applied via a tubing connection using a negative pressure pump. A new method of secondary wound closure using the transparent negative pressure dressing is presented based on a case example. The treatment cycle with instructions for making the dressing is shown in a video.

The use of occlusive dressings: influence on excisional wound healing in animal model.

PURPOSE: To analyze the influence of occlusive dressing on the healing of excisional skin wounds in mice. METHODS: Pre-clinical, comparative, and translational study. Mice were divided into three experimental groups: wounds occluded with hydrocolloid (HD) dressings, transparent polyurethane film (TF) dressings, and without occlusion (WO), monitored at three, six and 14 days, with eight animals each. Closure rate, infiltration of neutrophils and macrophages, measurement of tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) and, histologically, angiogenesis were evaluated. RESULTS: Wound closure was accelerated in the occlusive groups. There was a decrease in TNF-α levels in the HD group when compared to the WO and TF groups. Neutrophils accumulation decreased in the HD group. Increased dosages of macrophages were evidenced in the HD group, compared to the WO and TF groups. Levels of VEGF were increased in the TF and HD groups. CONCLUSIONS: It is suggested that the occlusion of wounds modulates the inflammatory response.

Comparison of silver-embedded occlusive dressings and negative pressure wound therapy following total joint arthroplasty in high BMI patients: a randomized controlled trial.

INTRODUCTION: High body mass index (BMI) and wound drainage following total joint arthroplasty (TJA) can lead to wound healing complications and periprosthetic joint infection. Silver-embedded occlusive dressings and negative pressure wound therapy (NPWT) have been shown to reduce these complications. The purpose of this prospective trial was to compare the effect of silver-embedded dressings and NPWT on wound complications in patients with BMI ≥ 35 m/kg2 undergoing TJA. METHODS: We conducted a randomized control trial of patients who had a BMI > 35 m/kg2 and were undergoing primary TJA between October 2017 and February 2020. Patients who underwent revision surgery, or those with an active infection, previous scar, history of wound healing complications, post-traumatic degenerative joint disease with hardware, or inflammatory arthritis were excluded. Patients were randomized to receive either a silver-embedded occlusive dressing (control) or NPWT. Frequency distributions, means, and standard deviations were used to describe patient demographics, postoperative complications, 90-day readmissions, and reoperations. T-test and chi-squared tests were used to test for significant differences between continuous and categorical variables, respectively. RESULTS: Two hundred-thirty patients with 3-month follow-up were included. One-hundred-fifteen patients received the control and 115 patients received NPWT. There were six patients (5.2%) in the control group with wound complications (drainage: n = 5, non-healing wound: n = 1) and two patients (1.7%) in the NPWT with complications (drainage: n = 2). There were no 90-day readmissions in the control group versus two (1.8%) 90-day readmissions in the NPWT group. Finally, three patients (2.6%) in the control group underwent reoperations (irrigation and debridement [I&D], I&D with modular implant exchange, and implant revision), while none in the NPWT group had undergone reoperation. The two groups showed insignificant differences in wound complications (p = 0.28), 90-day readmissions (p = 0.50), and reoperations (p = 0.25). CONCLUSION: Patients with BMI ≥ 35 m/kg2 undergoing TJA have no statistical difference in early wound complications, readmissions, or reoperations when treated with either silver-embedded dressings or NPWT.

Comparison of skin graft donor site management using oxidised regenerated cellulose (ORC)/collagen/silver-ORC with absorptive silicone adhesive border and transparent film dressing vs semi-occlusive dressings.

Split-thickness skin grafts (STSG) are widely used in wound reconstruction. However, donor site wounds are created as a result. Traditionally, moist wound healing and transparent film dressings have been used to promote donor site wound healing. This retrospective study evaluated the use of oxidised regenerated cellulose (ORC)/collagen/silver-ORC dressing (ORC/C/Ag-ORC) with an absorptive silicone adhesive border dressing and transparent film dressing (treatment) compared with petrolatum-based gauze dressing (control) over donor site wounds. Patients underwent an STSG procedure between January and December 2020. Donor sites received treatment (n = 10) or control (n = 10) dressings. Dressing changes occurred as necessary. Time to epithelialisation, narcotic pain medication requirements, and the number of office/hospital visits were examined. Twenty patients were managed (9 males, 11 females, average age: 49.7 ± 13.9 y). Patient comorbidities included hypertension, diabetes, and hyperlipidemia. Wound types included traumatic and cancer excision. Time to epithelialisation was significantly reduced in the treatment group (11.1 ± 1.4 d vs 18 ± 2.4 d, P < 0.0001). The number of office visits for dressing changes was significantly lower in the treatment group (0.1 ± 0.3 vs 2 ± 0.7, P < 0.0001). No patients in the treatment group required a hospital visit, compared with 3 patients in the control group. One patient in the treatment group required narcotic pain medication, compared with 5 in the control group. In this patient population, the use of ORC/C/Ag-ORC, an absorptive silicone adhesive border dressing, and transparent film dressing resulted in a shorter time to epithelialisation and less analgesic requirement compared with petrolatum-based gauze dressing use.

Curcumin Functionalized Electrospun Fibers with Efficient pH Real-Time Monitoring and Antibacterial and Anti-inflammatory Properties.

Wound infection has threatened the health of humans, and developing novel dressings by integrating infection detection and wound treatment in biomaterials is urgently required in the medical industry. In this study, we report a facile strategy to develop curcumin functionalized poly(ε-caprolactone) and gelatin composite fibrous membranes with pH real-time monitoring and antibacterial and anti-inflammatory properties. The developed curcumin-functionalized composite fibers displayed highly sensitive and visible response to the variation of the pH value of a buffer solution in the range of 5.6-8.6. In addition, the resultant fibrous membrane showed obviously enhanced antibacterial efficiency against both E. coli and S. aureus and no obvious cytotoxicity to human dermal fibroblasts when the curcumin content was less than 5 wt %. More importantly, 3 wt % curcumin-functionalized composite membrane exhibited excellent anti-inflammatory activities, good antioxidant activity of ca. 82%, and significantly decreased expression levels of pro-inflammatory cytokines like TNF-α and IL-6 in vitro (p < 0.001). Furthermore, subcutaneous embedding experiments showed that the 3 wt % curcumin-functionalized membrane significantly promoted cell penetration, recruited less macrophages, and facilitated collage deposition. Therefore, the curcumin-functionalized composite fibers could be employed to fabricate multifunctional dressings for the future treatment of chronic wounds.

Semi-occlusive dressing therapy versus surgical treatment in fingertip amputation injuries: a clinical study.

OBJECTIVES: Treatment of fingertip amputations is subject of controversial debates. Recently, semi-occlusive dressings have increased in popularity in these injuries. AIMS: To compare clinical outcomes of conservative semi-occlusive dressing therapy versus surgical treatment of fingertip amputations. METHODS: Eighty-four patients with fingertip amputations were re-examined clinically after a mean follow-up of 28.1 months (range 9.6-46.2). Sixty-six patients (79%) were treated with semi-occlusive dressings (group 1) and 18 (21%) underwent surgery (group 2). Range of motion, grip strength, and two-point discrimination were measured at the final follow-up. Furthermore, VAS score, Quick-DASH score, subjective aesthetic outcome and loss of working days were obtained. RESULTS: Group 1 demonstrated healing in all 66 patients (100%) while in Group 2 5 out of 18 patients (28%) failed to achieve healing after a mean of 17 days (range 2-38) due to graft necrosis. Group 1 showed significantly lower VAS scores and significantly lower loss of two-point discrimination compared to Group 2. Work absence was significantly shorter in Group 1 versus Group 2. Trophic changes in finger (46%) and nail (30%) were significantly lower in Group 1 compared to Group 2 (44% and 70%, respectively). Disturbance during daily business activities (14%) and cold sensitivity (23%) were significantly lower in Group 1 compared to Group 2 (86% and 77%, respectively). CONCLUSIONS: Semi-occlusive dressing therapy for fingertip amputations demonstrated excellent healing rates. Compared to surgical treatment, it resulted in significantly better clinical outcomes, lower complication rates and significantly higher reported satisfaction rates. Therefore, semi-occlusive dressing for fingertip injuries is a very successful procedure and shall be preferred over surgical treatment in most cases. LEVEL OF EVIDENCE: III therapeutic.

Preventing caesarean section wound complications: use of a silver-impregnated antimicrobial occlusive dressing.

OBJECTIVE: To investigate the role of an adherent soft silicone antimicrobial occlusive foam silver-impregnated dressing for reduction of surgical site infections (SSI) in primary low-transverse caesarean section (1°LTCS) delivery. METHOD: Women aged 18-45 years admitted to the labour and delivery or the antepartum unit undergoing a 1°LTCS were recruited. Exclusion criteria included repeat caesarean, vertical skin incision, intrapartum fever and closure with staples. Consented participants delivered by scheduled or unscheduled 1°LTCS received the silver-impregnated dressing. Those who declined to participate and were delivered by scheduled or unscheduled caesarean received a standard gauze with tape dressing (controls). Surgical preparation and preoperative antibiotics were administered as per hospital policy. RESULTS: A total of 362 participants were consented for use of the silver-impregnated dressing, with 190 participants undergoing 1°LTCS, of whom 185 were included in the final analysis. Of those who declined to participate, 190 ultimately underwent 1°LTCS during the same time period. Cases and controls were similar in demographics, body mass index, diabetes status, labour and procedure length, and tobacco use. The overall incidence of SSI was 3.7%. A 50% reduction in incidence of SSI was observed in the silver-impregnated dressing group compared with control group (2.7% versus 4.7%, respectively), but this was not statistically significant (p=0.08; odds ratio 0.55; 95% confidence interval: 0.18-1.67). CONCLUSION: Among women undergoing 1°LTCS with subcuticular closure of a transverse incision, use of a silver-impregnated dressing reduced the rate of SSI by >50% but was not statistically significant.

In vitro evaluation of a synthetic (Biobrane®) and a biopolymer (Epicite) wound dressing with primary human juvenile and adult fibroblasts after different colonization strategies.

BACKGROUND: The three-dimensional [3D] wound dressings Biobrane® and Epicite are used in the wound management. Fibroblasts are important for successful deep wound healing. The direct effect of Biobrane® and Epicite on human fibroblasts, particularly of juvenile individuals, remains unclear. Therefore, this study compared the survival and growth characteristics of juvenile and adult dermal fibroblasts on Biobrane® and Epicite using different culture models. METHOD: Murine (L929), primary juvenile and adult human fibroblasts were seeded on both materials using two dimensional (2D, slide culture) or 3D culture at the medium-air interface and dynamical rotatory culture. Cell adherence, viability, morphology, actin cytoskeleton architecture and DNA content were monitored. Scanning electron microscopy (SEM) analyses could be only performed from Biobrane®. Permeability of both materials were tested. RESULTS: The majority of all tested fibroblasts species survived on both dressings with no significant differences between 1 and 14 days. Juvenile and adult fibroblasts exerted typical fibroblast morphology with spindle-shaped cell bodies on the materials. SEM visualized morphological differences between murine and human fibroblasts on Biobrane®. Juvenile and adult fibroblasts colonized Biobrane® in rotatory culture after 7 days the most. The Biobrane® rotatory culture of L929 and juvenile fibroblasts showed after 7 days the significantly highest DNA amount. No major gender differences could be observed. Biobrane® had a higher permeability than Epicite. CONCLUSION: Both wound dressing can be colonized by fibroblasts suggesting their high cytocompatibility. Fibroblast survival and morphology on Biobrane® and Epicite depended on the culture system and the fibroblast source.

Semi-occlusive management of fingertip injuries with finger caps: A randomized controlled trial in children and adults.

BACKGROUND: Human fingertips can regenerate functionally and cosmetically excellent skin and soft tissues. Physiological conditions suppress scar formation and are thus a prerequisite for regenerative healing. Self-adhesive film dressings can provide such favorable conditions. The semi-occlusive treatment is superior to surgery. However, standard dressings leak malodorous wound fluid eventually until the wound is dry. Therefore, we developed and tested a silicone finger cap that forms a mechanically protected, wet chamber around the injury. Its puncturable reservoir allows access to the wound fluid for diagnostic and research purposes and the delivery of pro-regenerative drugs in the future. METHODS: Patients >2 years with full-thickness fingertip injuries unsuitable for simple primary closure were randomized to start treatment with either the film dressing or the silicone finger cap. After 2 weeks, we changed to the other treatment. Patients' choice on the preferred treatment after 4 weeks was the primary outcome parameter. Additionally, we monitored adverse events, unplanned visits, tissue gain, functionality, cosmetic outcome, and quality of life. RESULTS: We randomized 11 patients 2 to 72 years to each group. Eighteen to 20 (90%, intention-to-treat) patients preferred the finger cap. All patients were satisfied with the cosmetic outcome, 88.9% had no disturbing sensibility changes, and 73.7% could report no distortion in the finger's daily use. Epithelialization took between 5 weeks for Allen II and up to 9 weeks in Allen IV injuries. There were 19 device-related adverse events under film dressing and 13 under the finger cap. There were neither severe adverse device effects nor unexpected severe adverse device effects. CONCLUSION: Employing the summative or synthetic primary endpoint "patient decision for one or the other procedure," our pseudocross-over-designed RCT succeeded in statistically significantly demonstrating the superiority of the silicone finger cap over conventional film therapy. The finger cap was safe and effective, reaching excellent results on all treated injuries without any need for disinfection, antibiotics, shortening of protruding bones, or treatment of hypergranulations. Distal to the tendon insertions, we did not see any limitations regarding injury mechanism, amputation plane, or patients' age.

Use of chitosan-based dressings for the management of a chronic lower limb ulcer: a case report.

INTRODUCTION: Nonhealing ulcers are difficult to manage because they deviate from the normal wound healing process. The standard treatment with saline dressings is not efficient in treating patients with such wounds; advanced wound care dressings are needed. Chitosan-based advanced wound dressings are gaining popularity because of their unique characteristics, such as absorbency, conformability, and pain alleviation at the wound bed. A case of an ulcer that developed after cellulitis and healed with application of a chitosan-based dressing is presented. CASE REPORT: An 81-year-old female with hypertension was admitted to the hospital with a high-grade fever, generalized weakness, anorexia, and right lower limb pain with redness. Venous insufficiency in the right lower limb in the form of early insufficiency at the right saphenofemoral and saphenopopliteal junctions along with right leg varicosities was evident on color Doppler ultrasound. A diagnosis of cellulitis was made; the patient was treated with antibiotics and discharged from the hospital. The cellulitis progressed, and an incision and drainage of the right leg was performed on the second admission. The patient was admitted twice more, and the wound was surgically debrided twice and antibiotics were administered. During this period, the patient was treated with saline dressing changes for almost 4 weeks. Because the wound was nonhealing and infected during the fourth hospital admission, chitosan-based dressings were used. Daily dressing changes for 10 days resulted in 100% granulation tissue. Later, the patient underwent skin grafting and was eventually discharged. CONCLUSIONS: The use of chitosan-based dressings resulted in progression to complete granulation, along with the management of exudate, pain, and Pseudomonas infection. The results of this case suggest patients with nonhealing ulcers may benefit from early use of advanced wound care dressings.

An Absorbent, Flexible, Transparent, and Scalable Substrate for Wound Dressings.

Objective: Wound dressings that create and maintain a moist environment provide the optimal conditions for wound healing by increasing the rate of epithelialization and angiogenesis. However, current wound dressings require periodic removal which exposes the wound to the surrounding environment, thereby increasing the likelihood for infection and drying out the wound itself. There remains an unmet medical need for the development of an absorbent, flexible, and transparent wound dressing that can conform to the irregular geometry of the wound for a long-term duration. Herein, we report the development of AFTIDerm, an Absorbent, Flexible, Transparent, and Inexpensive moisture-management wound dressing using Polyvinyl alcohol (PVA) as the host material. Methods:AFTIDerm substrates of varying glycerol concentrations (1 wt%, 3 wt%, 5 wt%, 7 wt%, and 10 wt%) were fabricated and tested. The mechanical, absorption, and biological properties of AFTIDerm were evaluated. Results: We found that 5% glycerol served as the optimal concentration for AFTIDerm. The biocompatibility, absorptive capabilities, and scalability render PVA/glycerol an ideal material composition for wound dressings. Benchtop experimentation and pre-clinical testing demonstrate AFTIDerm as a platform for use in wound dressings. Discussion/Conclusion: The development of AFTIDerm broadens the translational utility of this materials platform not only as a material for wound dressings to minimize dressing changes in low to moderate exudate environments, but also as a potential substrate material for smart bandages. Clinical and Translational Impact Statement- AFTI Derm, an absorbent, flexible, and transparent wound dressing, maintains the moist environment required for healing while enabling monitoring of healing without removal and disruption to the wound bed.

Randomized, double-blind clinical trial comparing the healing of stasis ulcers in lower limbs with standard hydrocolloid gel dressings and with dressings with Syzygium cumini extract.

OBJECTIVE: To evaluate the healing of venous ulcers in the lower limbs (VLU) using dressings with hydrocolloid gel associated with Syzygium cumini extract (SHG) compared to standard hydrocolloid gel dressings (HG). METHOD: This prospective, double-blind, randomized trial recruited 90 patients with VLU divided into: dressings with SHG (n = 44) and dressings with HG (n = 46). Primary endpoint was healing in the 14th visit. Secondary endpoints were healing rate, complete healing during follow-up, and improvement in the pain scale and in quality of life. RESULTS: There were no significant between-group differences in healing (p = 0.15). The wound area made healing difficult (p = 0.008). Age, body mass index, and wound time demonstrated a tendency to worsen the healing. Positive culture for Pseudomonas aeruginosa resulted in 88% reduction in the healing risk (p < 0.0001). CONCLUSION: There was no difference between the dressings evaluated. The presence of Pseudomonas aeruginosa significantly impaired wound healing.

IV3000 semi-occlusive dressing use in simple and complex fingertip injuries: efficacy and affordability.

OBJECTIVE: This study aimed to explore the efficacy of the IV3000 semi-occlusive, transparent adhesive film dressing in the non-surgical management of simple as well as more complex fingertip injuries. METHOD: In this qualitative study, patients with fingertip injuries were prospectively recruited and treated conservatively with the dressing between 2015 and 2017. Inclusion criteria included any fingertip injury with tissue loss and patient consent for non-surgical treatment consistent with the study protocol. Exclusion criteria included injuries needing surgical intervention for tendon injury or exposure, joint dislocations, distal phalangeal fractures requiring fixation, bone exposure, isolated nail bed lacerations and any patients eligible for surgical repair who did not wish to be managed conservatively. RESULTS: A total of 64 patients took part in the study. The patients treated with the dressing were asked to rate functional outcome, of whom 40 (62.5%) patients reported the outcome as 'excellent', 19 (29.7%) as 'satisfactory', five (7.8%) as 'indifferent' and none (0%) as 'unsatisfactory'. A reduced pulp volume at completion of healing was felt by 21 (32.8%) patients, but all patients were 'satisfied' with the aesthetic appearance of their fingertips at final clinical review. Average healing time was 4.5 weeks across the group, with the average time for return to work being just under one week. We estimate a 60% reduction in cost with the conservative versus the surgical management option. CONCLUSION: This study showed that, for participants, the IV3000 dressing was an affordable and effective option for the conservative treatment of simple fingertip injuries and in the management of more complex fingertip injuries.

Quality improvement evaluation of postoperative wound dressings in orthopaedic patients.

Dressings play a key role in postoperative wound care, as clinicians aim to optimise the wound healing environment (including optimal exudate management) and prevent complications such as infection and blistering. Excess exudate can lead to wound breakdown, increased bacterial burden and delaying healing, causing an increased risk of wound infection (superficial) and ultimately increasing the risk of surgical site infection (SSI) (deep infection at the site of the prosthesis). This article describes the evaluation of different postoperative dressings in use within the orthopaedic department of a tertiary hospital, as part of a quality improvement program aimed at evaluating the performance of postoperative dressings and ensuring that the most appropriate dressing is used in the management of postoperative wounds in orthopaedic patients. Seven postoperative dressing types were assessed in 307 orthopaedic patients who had undergone surgery. Post-operative dressings were assessed in terms of their ability to handle exudate (in terms of both 'wet' exudate and 'dry' exudate). User satisfaction of the postoperative dressings was also captured. Dressing change frequency was also recorded. Dressing wear was captured in terms of whether the post-operative dressing under evaluation was still in place at the time the patient was discharged (if the primary dressing required changing, it was replaced with Tegderm™ +Pad, as per current hospital practice.) Most healthcare professionals were satisfied, very satisfied or extremely satisfied with the ease of application of the dressings: Mepore® non-occlusive fabric dressing (96%) (current practice), Opsite® Post-Op Visible (95%), Leukomed® Control (94%), Sorbact® (green) surgical dressing (90%), Mepilex® Border Post-Op (87%), Tegaderm®+Pad (76%) and Aquacel® Ag Surgical (73%). The high satisfaction rates for Mepore® may have been influenced by the familiarity with this dressing which, at the time, was the standard current practice dressing. This dressing was ruled out for future use due to it being non-occlusive. Opsite® Post-Op Visible (second highest rating) was associated with three adverse events. Sorbact® surgical dressing was rated fourth in terms of healthcare professional satisfaction with regards to ease of application but was associated with the highest amount (24%) of wet exudate. Mepilex® Border Post-Op (rated fifth for ease of application; 5% wet exudate) was preferred overall because of its flexibility and small amount of wet exudate, ahead of Leukomed® Control (rated third for ease of application; 12% wet exudate), which had more frequent dressing changes than recommended by the manufacturer. A contributory factor to this may have been the dressing's transparency and the ability to observe the small amount of exudate and the nurse feeling the need to change it. In response to the findings of the quality improvement program, a new protocol of care at the major metropolitan teaching hospital has been implemented; for patients undergoing orthopaedic surgery, Mepilex® Border Post-Op (Mölnlycke) is now routinely applied in theatre and is left intact for 7 days as per the manufacturer's recommendations. Since this change in practice and the introduction of Mepilex® Border Post-Op, the incidence of SSIs at this hospital has reduced.

The Ideal Donor Site Dressing: A Comparison of a Chitosan-Based Gelling Dressing to Traditional Dressings.

Donor site wound management is critical in split-thickness skin graft surgeries. These sites typically recover in 7 to 14 days due to the dermal-imbedded keratinocytes that promote skin regeneration. An ideal donor site dressing can help to mitigate pain, reduce infection risk, promote hemostasis, and accelerate healing times. Additionally, this dressing would be easy to apply in the operating room, easily managed, and cost-effective. Chitosan-based gelling dressings (CBGD) possess many of these qualities that make an ideal donor site dressing. We conducted a retrospective chart review of patients who received CBGD as part of their postoperative wound care plan. We collected data on infections, hemostasis, dressing failure, and hospital course over a 14-month period where CBGD was used as the donor site dressing. One hundred and fourteen patients were evaluated. We found an infection rate of 7%, a bleed-through rate of 1.8%, and a re-application rate of 9.6%. The average CBGD cost per patient was $75.15. CBGD has acceptable infection rates, and pain scores as traditional donor site dressings. However, it possesses several qualities of a suitable donor site dressing notably swift healing rates, impressive hemostatic property, and low cost. Our study supports the idea that CBGD is a suitable donor site dressing for split-thickness skin graft surgeries.