Effect of autologous skin paste on repairing wound of donor site of medium-thickness skin graft

Abstract

Objective: To explore the effect of autologous skin paste on repairing wound of medium-thickness skin donor site. Methods: The prospective randomized controlled research method was applied. From October 2018 to December 2019, 18 patients with flame burn or hydrothermal scald, met 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, and the wounds were repaired with medium-thickness skin grafts. The wound area after medium-thickness skin grafting was (121±33) cm2. The wound of donor site of medium-thickness skin graft in each patient was divided into 2 wounds in equal area and included into autologous skin paste group and conventional treatment group with random number table, 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 repaired with petroleum jelly gauze and sterile gauze. On 3, 7, 14, 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 subcutaneous effusion and infection on 3, 7, 14, 21 d after operation and wound rupture 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±1.4) 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, 21 d after operation, there were no complications such as subcutaneous effusion and 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 wounds with ulceration healed after dressing change. 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). Conclusion: The remaining fragments after autologous medium-thickness skin grafting are prepared into skin paste to repair wound of donor site of medium-thickness skin graft can shorten wound healing time, improve wound healing quality, reduce degree of scar hyperplasia, which has a good clinical effect.