The use of biobrane II and specialty airflow beds (FluidAir Plus and Kinair for effective coverage of extensive posterior donor site wounds.

Abstract

Posterior skin graft donor sites furnish large areas of skin for wound coverage, but the sites frequently are management problems. The wounds tend to become moist and to develop excessive drainage and fluid accumulation that may interfere with adherence of dressings, including our preferred donor site dressing, Biobrane II (red label, large pore). We studied the use of specialty airflow beds for improving the outcome of posterior donor sites. We evaluated 50 patients aged 1 to 69 years (mean 29.45 years) with posterior skin graft donor sites of the back, thigh, or buttocks that were covered with Biobrane II. Sites ranged in size from 3% to 13% body surface area (mean 8.34%). Forty patients were placed on a FluidAir Plus bed, and 10 were placed on air-filled pillow therapy beds (five on KinAir III, five on Therapulse) (Kinetic Concepts, Inc.) All patients were kept in the supine position. We evaluated six criteria: drainage, fluid accumulation under Biobrane, infection, days until Biobrane separated, days until epithelialization, and days of specialty bed usage. We related these criteria to nursing-care actions that interfere with airflow and prevent the drying action of the bed, such as use of a "linen saver" under the patient in the area of the donor site, a foam wedge under the back, and dressings applied over the Biobrane. Most donor sites had no complications. Donor site infections developed in six patients. Five of these patients had fluid accumulation under the Biobrane, necessitating early removal. Fluid accumulated under the Biobrane in 21 patients; nine of these incidences were related to a nursing-care action that impeded airflow.(ABSTRACT TRUNCATED AT 250 WORDS)