Abstract

Herein, we compare the outcomes of polyurethane and calcium alginate dressings for split-thickness skin graft (STSG) donor sites.A systematic review and meta-analysis were conducted with a search of electronic databases to identify all randomised controlled trials (RCTs) and observational studies comparing the outcomes of polyurethane dressing versus calcium alginate for STSG donor sites. Primary outcomes were pain intensity, convenience for staff and patients, and adverse effects (namely, excessive exudate, infection rate, and hematoma). Secondary outcome measures included the assessment of healing, dressing changes, cosmetic appearance, and cost. Fixed and random-effect models were used for the analysis.Four RCTs enrolling 127 subjects were identified. There was no significant difference between polyurethane and calcium alginate in terms of pain intensity on Day 1 (mean difference (MD) 0.13, P = 0.80) and Day 5 (MD = 0.20, P = 0.38), as well as the ease of application (odds ratio (OR) = 3.08, P = 0.47). However, there was a statistically significant improvement in patient comfort, favouring the polyurethane group (OR = 44.11, P < 0.00001). In addition, no statistically significant differences were noted in terms of adverse effects between the two dressings. In terms of cost, the calcium gluconate dressing had an overall higher cost compared to polyurethane.Polyurethane is a more favourable dressing compared to calcium alginate for STSG donor sites in terms of patient comfort, healing, and cosmetic outcomes. However, comparable results were noted in terms of pain intensity, ease of application, and adverse effects profile. Cost-effectiveness analysis studies are required to justify its routine use.

Highlights

  • BackgroundSeveral dressing options are used for donor sites of split-thickness skin grafts (STSG); yet, no gold standard exists

  • We compare the outcomes of polyurethane and calcium alginate dressings for split-thickness skin graft (STSG) donor sites

  • A systematic review and meta-analysis were conducted with a search of electronic databases to identify all randomised controlled trials (RCTs) and observational studies comparing the outcomes of polyurethane dressing versus calcium alginate for STSG donor sites

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Summary

Introduction

Several dressing options are used for donor sites of split-thickness skin grafts (STSG); yet, no gold standard exists Dressings differ in their ability to optimize donor site morbidities, such as pain, infection, delayed wound healing, and exudate formation, in addition to their cost-effectiveness [1-5]. Polyurethane dressings are preferred for their ability to maintain a high degree of moisture which prevents their adherence to the wound bed, reducing pain, maintaining patient comfort, and supporting rapid healing without difficulty. Due to their flexibility, they act as a second skin layer to contain wound exudate to prevent bacterial contamination and trauma to the wound [7-10]

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