gms | German Medical Science

Skin graft donor sites in high-risk wound patients warrant intense treatment and optimal wound-management techniques. Creating a donor site increases the body surface area injured and causes a further trauma. The development of infection at donor sites delays healing and can even convert the donor site injury to a full-thickness wound. The optimal treatment for spilt-thickness graft donor sites remains unclear. An ideal dressing method prevents dehydration and infection while facilitating wound healing. Dressings should be easy to apply and require minimal care. The need for rapid wound closure and regeneration of viable epidermis for example recropping has prompted the development of skin equivalents that can be used for donor sites. Suprathel^® is produced from a synthetic copolymer consisting mainly of DL-lactide (>70%), trimethylcarbonate, and ε-caprolactone. It represents a synthetic dressing that imitates the properties of natural epithelium.

At KUH (Kuopio University Hospital) we have used Suprathel^® on skin graft donor sites in high-risk patients for wound healing (total amount of 10). Patients include major burn patients and elderly patients with donor sites due to cancer or trauma wounds. Patients with minimum age of 13 and with maximum age of 91 were included. Skin donor sites were measured at least 16 cm x 10 cm or larger and were located on various anatomical sites including scalp, upper and lower extremities, back. Treatment consistency was achieved by always harvesting in one-pass technique performed by the same surgeon. Prior dressing application, a gauze soaked in epinephrine-saline solution (1 mg of epinephrine in 1 l of 0.9% saline) was temporarily used to the freshly harvested donor sites. To avoid gauze adherence Suprathel^® was directly covered with a parafin gauze serving as a interlayer. The outer layer of dressings were untouched until 2nd day after operation and then dry gauzes covering Suprathel^® were changed twice a week until epithelisation was complete.

Throughout the treatment period no infection was detected in any donor site. No allergic reaction to Suprathel^® was reported. Mobilization without any problem due to donor sites was noticed. Patients and nursing staff approved the smooth detachment of Suprathel^® from the donor sites. No donor sites were lost in patients with major burns treated with Suprathel^® on donor sites. Nursing staff documented good ease of care with simple material application and straightforward dressing changes.

Even though Suprathel^® overall treatment costs may be high compared to many other products used for donor sites, it has shown promising results in high-risk wound patients. Uneventful healing of donor sites may reduce morbidity and even mortality in selected patients. These findings have been detected in highly selected challenging clinical cases and need further studies.