Influence of polyester gauze on evaporation capacity and healing of the surface of microskin graft wound after escharectomy

Abstract

To investigate the influence of polyester gauze on evaporation capacity and its clinical effect after escharectomy of deep burn wound and micro-skin grafting. Twenty patients with deep burn admitted within 24 hours after injury underwent escharectomy and Meek skin grafting. Two surfaces of wound with the area of about 1% as the whole wound surface were used, one covered by Meek skin graft and polyester gauze as inner dressing (polyester gauze group), and the other covered by split-thickness skin sheet 0.3 mm x 0.3 mm in size and vaseline oil gauze as inner dressing (vaseline oil gauze group). Five days after skin grafting, the evaporation capacities of the surface of inner dressing, wound surface without dressing (nude wound), and normal skin near the wound were tested by evaporation test equipment. The complete healing time and survival rate of skin sheet in both groups were observed. The degree of pain during dressing change was evaluated with visual analog scale. The evaporation capacity of the inner dressing surface of polyester gauze group was (24.8 +/- 5.2) ml x h(-1) x m(-2), significantly lower than those of the vaseline oil gauze group [(35.4 +/- 5.0) ml x h(-1) x m(-2), P < 0.01] and nude wound [(41.3 +/- 4.5) ml x h(-1) x m(-2), P < 0.01], and similar to that of the normal skin near the wound [(21.1 +/- 5.1) ml x h(-1) x m(-2), P > 0.05]. The evaporation capacity of the inner dressing surface of vaseline oil gauze group was significantly lower than nude wound [(40.7 +/- 3.6) ml x h(-1) x m(-2), P < 0.01], but significantly higher than the normal skin near the wound [(21.2 +/- 3.8) ml x h(-1) x m(-2), P < 0.01]. The survival rate of skin sheets of the polyester gauze group was 98% +/- 3%, not significantly different from that of the vaseline oil gauze group (98% +/- 2% , P > 0.05). The wound healing rates on days 10, 15, and 20 of the polyester gauze group were 80% +/- 20%, 96% +/- 7%, and 100% respectively, all significantly higher than those of the vaseline oil gauze group (70% +/- 33%, 81% +/- 21%, and 97% +/- 11% respectively, all P < 0.01). The complete healing time of the polyester gauze group was (13.6 +/- 1.9) days, significantly shorter than that of the vaseline oil gauze group [(16.7 +/- 2.6) days, P < 0.01]. The pain scores during dressing change 5 and 10 days after grafting of the polyester gauze group were (3.2 +/- 0.8) and (4.9 +/- 0.4) respectively, both significantly lower than those of the vaseline oil gauze group [(5.1 +/- 0.6) and (8.2 +/- 0.5) respectively, both P < 0.01]. Polyester gauze has quite good abilities to retain moisture and can promote the migration and proliferation of epithelial cells, relieves the pain caused by tearing of dressings off the wound, thus raising its acceptability. It is a relatively ideal carrier of skin grafting, as well as a new type of inner cover for the wound.