Biological versus non-biological dressings in the management of split-thickness skin-graft donor sites: a systematic review and meta-analysis

Author:

Rahman Shafiq1,Langridge Benjamin2,Al-Hadad Ahmed3,Khan Rehman Ali4,Junejo Muhammad Hyder5,Mosahebi Afshin26

Affiliation:

1. Hull Royal Infirmary

2. Royal Free Hospital, London

3. University College London

4. Cardiac and Thoracic Surgery, Royal Victoria Hospital, Belfast

5. Genitourinary Medicine, Chelsea and Westminster Hospital, London

6. Division of Surgery and Interventional Science, University College London

Abstract

Objective: There are currently no definitive guidelines regarding the management of split-thickness skin-graft (STSG) donor sites. The literature reports biological and non-biological dressings as the two main groups; however, there is no conclusive evidence regarding the ideal type. A systematic review and meta-analysis of existing clinical trials was performed to compare biological and non-biological dressings in managing STSG donor sites. Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards was used to conduct this study. Electronic databases including MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched by two authors (SR and BL). Data analysis was performed with RevMan 5.3. Results: In total, 10 studies, consisting of eight randomised controlled trials and two observational assessments, were identified. Wound healing time was faster with biological dressings compared to non-biological dressings (mean difference -5.44 days; p<0.05). A higher epithelialisation rate was also noted for biological dressings. There was no difference in the infection rate between the two study groups (odds ratio [OR] 0.39; 95% confidence interval [CI] 0.15–1.04) or wound exudation (OR 0.31; 95% CI 0.01–8.28). The pain level experienced during dressing changes in both groups was reported to be similar. Conclusion: The rate of epithelialisation and wound healing is greater for STSG donor sites when treated with biological dressings, but they offer no difference in terms of reducing pain, limiting infection or exudation.

Publisher

Mark Allen Group

Subject

Nursing (miscellaneous),Fundamentals and skills

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