Wound-Psychosocial and Quality of Life Aspects

Abstract

INTRODUCTION: The treatment of acute partial-thickness donor graft sites that are created during the harvesting process has traditionally received little clinical attention. Occurrence of pain during the healing process is common, especially when the choice of dressings is not clinically appropriate. In our Head and Neck Oncology practice, skin grafting is a common intervention, and the availability of a product based on 100% native collagen, especially one that offers a molecular basis for pain control merited trial on patients. MATERIALS AND METHODS: Four patients who underwent skin harvesting procedures were treated with the Microscaffold dressing. Dressings were applied after hemostasis was achieved with gauze, and the secondary application of a polyurethane film, followed by a gauze/compression bandage kept the collagen in place. On day 2, the gauze/compression bandage was removed, with the polyurethane film left in place. On two of the patients, the polyurethane cover was removed on day 5, and on the other two, the polyurethane was left in place. Pain was monitored constantly using the Wong-Baker scale. Healing was monitored visually on days 5 to 10 on all patients following the procedures. RESULTS AND DISCUSSION: We found that pain was remarkably absent on the patients during the course of healing. Pain was absent when the polyurethane film was left in place, which is consistent with the principles of moist wound healing. Healing was uneventful and without immediate scarring in all patients. The pain reduction observed can be hypothesized to occur because of the potential ability of the collagen to bind elastase, an enzyme that is responsible for generation of the pain causing molecule, bradykinin, via a proteolytic event.