Abstract
BackgroundFor children requiring split-thickness skin grafting for burn injury, the optimum donor site dressing is an ongoing subject of debate. The most common dressings in use, both regionally and worldwide, are calcium alginates. We will compare an alginate with two other dressings, all of which are in current use in the Pegg Leditschke Paediatric Burns Centre (PLPBC), to determine which dressing performs the best.Methods/DesignThis is a randomised, prospective single center parallel three-arm trial comparing three donor site wound (DSW) dressings: Algisite™ M, a calcium alginate dressing; Cuticerin™, a smooth acetate gauze impregnated with water-repellent ointment (petrolatum, paraffin and Eucerite®) and Sorbact®, a gauze mesh coated with a dialkylcarbamoyl chloride (DACC) and amorphous hydrogel.Primary outcomes are days to complete DSW healing, and pain. Previously validated measures will be used for all outcomes. Secondary outcomes are: itch; scar appearance at three, six and 12 months; ease of dressing application and removal and dressing costs and utility. Results will be analysed on an intention-to-treat basis. Donor site thickness will be measured with a small biopsy from the center of the graft, to document the depth of the DSW across the groups.DiscussionThis study will provide comprehensive short- and long-term data on DSW dressings in pediatric split-thickness skin grafting. The best-performing dressing will become the preferred dressing for the PLPBC. We will provide rigorous data against which other dressings can be compared in future, recognising that alginates are the most common DSW dressing currently in use. Our study design replicates a real-world scenario in order to identify clinically significant differences between the three dressings.Trial registrationThis trial was prospectively registered on 8 April 2014 with the Australia and New Zealand Clinical Trials Register (identifier: ACTRN12614000380695).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-0557-9) contains supplementary material, which is available to authorized users.
Highlights
For children requiring split-thickness skin grafting for burn injury, the optimum donor site dressing is an ongoing subject of debate
The best-performing dressing will become the preferred dressing for the Pegg Leditschke Paediatric Burns Centre (PLPBC)
We will provide rigorous data against which other dressings can be compared in future, recognising that alginates are the most common donor site wound (DSW) dressing currently in use
Summary
For children requiring split-thickness skin grafting for burn injury, the optimum donor site dressing is an ongoing subject of debate. The most common dressings in use, both regionally and worldwide, are calcium alginates. We will compare an alginate with two other dressings, all of which are in current use in the Pegg Leditschke Paediatric Burns Centre (PLPBC), to determine which dressing performs the best. Split-thickness skin grafting (STSG) is the most widely used method of achieving skin coverage in burns that are not predicted to heal rapidly with dressings. The optimum dressing for the DSW is unclear, with surgeon and centre choice appearing to follow tradition stemming from eminence as often as it follows selection stemming from evidence. There is a clear need for high quality evidence in pediatric DSW dressings
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