A quest for optimizing skin graft donor site healing by prospective randomized comparative evaluation of biologic cadaver skin graft dressings versus ionic silver impregnated foam dressings in 200 patients at a tertiary burn unit
Manpreet Kaur Juneja, Vedanti Rajesh Patil, Ateesh Borole, Suhas Vidyadhar AbhyankarBackground:
Recent advances in wound care have devised a wide variety of dressing materials to optimize wound healing. However, due to such wide heterogeneity and lack of insufficient clinical trials, there is no “universally ideal” dressing identified yet. The aim of this study was to optimize skin graft donor site healing by comparing the effectiveness of cadaver skin graft dressing and ionic silver impregnated foam dressings.
Methodology:
A prospective, randomized controlled trial involving 200 patients was conducted from April 2023 to December 2024 at a tertiary burn unit. Patients were randomized to receive either ionic silver impregnated foam dressing or cadaver skin graft dressing. Primary outcome measures included Patient and Observer Scar Assessment Scale (POSAS) scores, whereas secondary outcomes comprised Visual Analog Scale pain scores, wound healing time, and infection rates.
Results:
Ionic silver impregnated foam dressing group demonstrated statistically significant advantages on postoperative day 21 as per POSAS patient and observer scores, while at 6 months interval, POSAS observer scores remained significantly better in cadaver skin group and POSAS patient scores showed comparable satisfaction. Cadaver skin group showed superior wound healing and pain control. While infection rates were lower in cadaver skin group, this difference was not statistically significant (
Conclusion:
Although short-term results favour cadaver skin graft dressings over ionic silver impregnated foam dressings, both dressing methods are viable options for donor site management when considering long-term results. Although none can be labelled as “universally ideal,” both have proved to be “patient-specific ideal,” provided that the choice is guided by the availability and patient-specific clinical circumstances.