Associated use of silicone-vitamin E gauzes and α-tocopherol acetate oil in healing of skin graft donor sites

Abstract

Split-thickness skin graft is one of the most used procedures in plastic surgery. This procedure involves numerous painful dressings at the donor site. α-Tocopherol acetate has anti-oxidative and anti-inflammatory properties and it can reduce the local bacterial growth, thereby promoting wound healing. We designed a prospective study to evaluate the effects of two different kinds of dressings at skin graft donor sites. A total of 30 patients were subjected to daily dressings with α-tocopherol acetate oil and traditional moist gauzes (group 1). Another 30 patients were subjected to dressings every 4 days with α-tocopherol acetate oil and silicone-vitamin E gauzes (group 2). Healing time, infection rate, patient's pain perception and costs were evaluated in both the groups. No statistically significant difference was found in terms of healing time. The infection rate was slightly different in the two groups. Significant reduction of pain perception was detected in group 2. In the same group, significant reduction in the total cost of the treatment was also observed. α-Tocopherol acetate oil and silicone-vitamin E gauzes may represent a safe, simple, painless and inexpensive method for improving skin graft donor site healing.

Keywords: Silicone gauze; Skin graft donor site; Wound healing; α-Tocopherol acetate.

Figure 1

(A) Split‐thickness skin graft (STSG) donor site (right thigh) 4 days post‐operation after the removal of polyurethane dressing. (B) STSG donor site dressing with α‐tocopherol acetate (TA) oil (Vea Oil; Hulka, Rovigo, Italy). Four layers of moist gauze (Fitostimoline gauze; Farmaceutici Damor Spa, Napoli, Italy) were placed in a small area (circled). A single layer of silicone‐–vitamin E gauze with α‐TA oil (Vea Sil; Hulka) was placed on the remaining part of the wound. Vea Sil gauzes were left on‐site for 4 days, while Fitostimoline gauzes were changed daily during this period. (C) STSG donor site 8 days post‐operation. The part of the wound dressed with Fitostimoline (circled area) is still bleeding after removal, while the remaining part of the wound, dressed with Vea Sil, appears to have a more advanced healing. After this dressing, the patient, comparing the pain between the two kinds of dressings, refused to use traditional moist gauzes. (D) STSG donor site 15 days post‐operation. The healing was completed using Vea Oil and Vea Sil, changed every 4 days, on the whole area.

Figure 2

(A) Split‐thickness skin graft donor site (left thigh) of patient recruited in group 2 after the removal of the polyurethane foam. (B) Four days post‐operation. First dressing with Vea Oil and Vea Sil changed every 4 days in the following period. (C) 21 days post‐operation. Healing completed.

Figure 3

(A) 15 days post‐operation. In this patient, during the first 2 weeks, the dressings were changed every day only with normal moist gauzes (Fitostimoline). There is an infection in the donor site with copious exudate. The patient reported high level of pain (visual analogic scale score: 9) during the dressing change because of the adhesion of the moist gauzes to the wound. (B) 15 days post‐operation. Removing the normal moist gauzes shows the presence of bleeding. From now on, Vea Sil gauze replaced the moist gauzes. (C) 19 days post‐operation. After 4 days of the treatment with Vea Oil and Vea Sil, the reduction of the exudate is appreciable. (D) 19 days post‐operation. Change of the dressing after 4 days of treatment with Vea Oil and Vea Sil. Healing is in progress. (E) 30 days post‐operation (15 days of treatment with Vea Oil and Vea Sil). Healing is completed.