Evaluation of a combined calcium sodium alginate and bio-occlusive membrane dressing in the management of split-thickness skin graft donor sites

The optimal treatment of the split-thickness skin graft (STSG) donor site r emains an unresolved issue. This study was conducted to evaluate the combin ed use of calcium sodium alginate and a bio-occlusive membrane dressing in the management of STSG donor sites. This study was a prospective evaluation of all patients requiring an STSG over a B-month period ending October 199 8. There were 57 patients with a mean age of 61 years. All skin grafts were harvested with an electric dermatome from the anterior thigh and were 0.01 2 to 0.016 inches thick. Donor sites were dressed with calcium sodium algin ate followed by a bio-occlusive dressing. Postoperatively, the skin graft d onor site dressing was removed and replaced. The mean skin graft area was 1 14 cm(2). The first dressing change occurred, on average, 3 days postoperat ively. All dressings were taken down and the wounds reevaluated 7 days post operatively. Fifty-two patients (91%) had achieved complete reepithelializa tion by this time. Five patients (9%) required an additional dressing. All wounds were healed completely by postoperative day 10. Donor site discomfor t was minimal and limited to the time of dressing change. There were no wou nd-related complications. The average cost of dressing supplies was $48.00 per patient and $23.00 per dressing. This method of managing STSG donor sit es allowed for unimpeded reepithelialization without wound complication. Th e bio-occlusive dressing eliminated the pain typically associated with fine mesh gauze dressings. The absorptive property of the calcium sodium algina te eliminated the problem of seroma formation and leakage seen routinely wi th the use of a bio-occlusive dressing alone. These results confirm that th is technique is both efficacious and cost-effective.