[Prospective randomized controlled study on clinical effects of autologous skin paste in repairing medium-thickness skin donor site wounds].

ABSTRACT

Objective: To explore the clinical effects of autologous skin paste in repairing medium-thickness skin donor site wounds. Methods: The prospective randomized controlled research method was applied. From October 2018 to December 2019, 18 patients with flame burn or hydrothermal scald, conforming to the inclusion criteria were admitted to Jinhua Hospital Affiliated to Zhejiang University School of Medicine, including 15 males and 3 females, aged (45±6) years. The wounds were repaired with medium-thickness skin grafts from thigh, and the wound area was (121±33) cm2 after medium-thickness skin grafting. The medium-thickness skin donor site wound in each patient was divided into 2 wounds in equal area and allocated into autologous skin paste group and conventional treatment group by flipping a coin, with 18 wounds in each group. The wounds in autologous skin paste group were repaired with skin paste prepared with remaining skin fragments after autologous medium-thickness skin grafting, and the wounds in conventional treatment group were covered with petroleum jelly gauze and fixed with sterile gauze. On 3, 7, 14, and 21 d after operation, the wound healing in 2 groups was observed, and the wound healing rate was calculated. The wound healing time in 2 groups was recorded. Occurrences of wound subcutaneous effusion and infection on 3, 7, 14, and 21 d after operation and wound ulceration in 3 months after operation were observed. In 6 months after operation, the Vancouver Scar Scale (VSS) was used to evaluate the scar formation of wounds in 2 groups. Data were statistically analyzed with analysis of variance for repeated measurement, chi-square test, and group t test. Results: The wounds in 2 groups did not heal on 3 and 7 d after operation. The wound healing rate in autologous skin paste group was (29.8±2.5)% and (95.6±4.7)% on 14 and 21 d after operation, which were significantly higher than (25.8±2.9)% and (82.6±8.9)% in conventional treatment group (t=4.3, 5.6, P<0.01). The wound healing time in autologous skin paste group was (21.8±1.6) d, which was significantly shorter than (25.6±2.0) d in conventional treatment group (t=6.24, P<0.01). On 3, 7, 14, and 21 d after operation, there were no complications such as subcutaneous effusion or infection in wounds of 2 groups. In 3 months after operation, ulceration occurred in wounds of 2 patients in autologous skin paste group, which was significantly less than 12 patients in conventional treatment group (χ2=11.688, P<0.01). The ulcerated wounds healed after dressing changes. In 6 months after operation, the VSS score of wounds in autologous skin paste group was (9.1±1.1) points, which was significantly lower than (11.3±1.2) points in conventional treatment group (t=-5.75, P<0.01). Conclusions: The remaining skin fragments after autologous medium-thickness skin grafting prepared into skin paste to repair medium-thickness skin donor site wounds can shorten wound healing time, improve wound healing quality, and reduce degree of scar hyperplasia, with a good clinical effect.