Efficacy Analysis of Split Thickness Skin Graft Donor Site Wound Care: A Systematic Review and Meta-analysis

• Main Authors: I-Chun Lin, 林怡君
• Other Authors: Chu-Yun Lu
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/ds6veh

碩士 === 義守大學 === 醫務管理學系 === 105 === Background: Split-thickness skin grafts (STSG) have been widely used in wound reconstruction, because it could decrease the duration of wound healing and minimize scar contracture. Skin grafting, however, can result in extra wounds, i.e., donor sites. Because standard care guideline for donor site is inconclusive, poor implications, such as increased wound pain, delay of wound healing, hypertrophic scar, and even infection may occur. Purpose: This study is aimed to analyze efficacy of dressing types for skin grafting donor site care, using a literature review and meta-analysis design. Methods: A comprehensive literature search was conducted to identify research publications between Jan 2009 and June 2016 that were addressed on outcomes of dressing types for split-thickness skin graft donor sites in the PubMED, MEDLINE, CINAHL, and Chinese databases (including CEPS). Research inclusion criteria were: 1) a clinical trial design; 2) adults receiving STSG; 3) study outcomes on pain, healing time, or complication. Comprehensive Meta-Analysis 3.0 software was applied to examine the effect size of the three outcome variables. Results: A rough search was resulted in 454 relevant studies; of them, five publications were met the study inclusion and exclusion criteria. For the purpose of the study, types of dressing were divided into two categories: absorb vs. non-absorb. As if there are more than two types of wound care dressing used in the publication study, multiple data entries would be occurred. A significant level 0.05 is applied in the current study. There are five publications and 8 data entries included in pain outcome analysis. The overall effect of pain between absorb and non-absorb groups is -0.002 (95% confidence interval (CI), -0.348, 0.344), which is insignificant. There are five publications and 7 data entries included in healing time outcome analysis. The overall effect of healing time between absorb and non-absorb groups is -0.408 (95% CI, -0.816, 0.000), which is insignificant. There are five publications and 6 data entries included in complication outcome analysis. The overall effect of complication between absorb and non-absorb groups is 0.610 (95% CI, 0.139, 2.672), which is insignificant. Conclusion: The study result supports absorb wound care dressing is benefit for wound healing. It is important to implement such dressing type as standard wound care.