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Split-Thickness Graft Sites Heal In Weeks With Matrix Dressing


 

BALTIMORE — Oasis wound matrix provides a low-maintenance scaffold for split-thickness skin graft donor sites to grow new epidermis over several weeks without significant pain for the patient, Dr. James C. Yuen said in a poster presented at the annual meeting of the American Society of Plastic Surgeons.

Since Oasis was approved by the Food and Drug Administration in 2000, few articles have been published on its use, none of which describes using it for dressing split-thickness skin graft donor sites, according to Dr. Yuen of the division of plastic and reconstructive surgery at the University of Arkansas, Little Rock.

Oasis is derived from porcine intestinal mucosa and acts as an extracellular matrix to support cell adherence, he said.

The material contains key components of the dermal extracellular matrix (collagen, elastin, glycosaminoglycans, glycoproteins, proteoglycans, and growth hormones) to promote rapid cellular proliferation and capillary ingrowth.

During 2003–2006, Dr. Yuen and his colleague, Dr. Julio Hochberg, also of the university, used Oasis to reepithelialize split-thickness skin graft donor sites on the thighs of 131 patients.

Epithelialization was complete after 1–3 weeks in all but two patients who had delayed healing beyond 1 month. Few patients experienced significant pain at the donor site because the material protects nerve endings, the investigators suggested.

Once Oasis is placed directly over the wound, Xeroform (Kendall Inc.) is placed to cover the matrix, followed by nonadherent Telfa gauze (Kendall), 4-by-4-inch dry gauze pads, and then Tegaderm tape (3M Health Care) for smaller donor sites or a circumferential wrap with Kerlix (Kendall) for larger sites. Dr. Yuen said that neither he nor Dr. Hochberg has any conflicts of interest with the manufacturers of any the products used in the procedure.

The investigators typically changed the dressing 4–6 days after surgery, but it was done earlier if there was excessive drainage soaking through the dressing.

Subsequent dressing changes occurred every 2–3 days, leaving the Oasis wound matrix and Xeroform in place each time.

The scab-like wound matrix peels off easily after reepithelialization is complete, Dr. Yuen said.

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