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Plastic Surgery117 papers

Infection of skin donor site

Last edited: 3 h ago

Overview

Infection of skin donor sites, particularly those created for split-thickness skin grafts (STSG), is a significant complication that can impede healing, prolong hospital stays, and negatively impact cosmetic outcomes. This condition primarily affects patients undergoing reconstructive surgery for burns, trauma, or oncologic resections, where donor sites are often located on the thigh, forearm, or scalp. Effective management of donor site infections is crucial in day-to-day practice to minimize morbidity and optimize patient recovery 1 5 10.

Pathophysiology

The pathophysiology of donor site infections typically begins with breaches in the skin barrier during harvesting, exposing underlying tissues to potential pathogens. Common sources of contamination include the surgical environment, patient flora, and external factors like poor wound care practices. Once breached, the wound undergoes an initial inflammatory phase characterized by neutrophil infiltration and exudate production, creating an environment conducive to bacterial colonization 1 10. If not promptly managed, this can progress to deeper tissue involvement, leading to abscess formation, delayed healing, and systemic complications such as sepsis 1 20.

Epidemiology

The incidence of donor site infections varies but is generally reported to occur in 5-15% of cases following STSG procedures 1 10. These infections disproportionately affect patients with compromised immune systems, those undergoing extensive grafting, and those with preexisting comorbidities like diabetes or peripheral vascular disease 1 14. Geographic and demographic factors also play a role, with higher rates observed in resource-limited settings where sterile techniques and post-operative care may be suboptimal 1 18. Trends over time suggest improvements with better surgical techniques and advanced wound care modalities, though variability persists 1 19.

Clinical Presentation

Typical presentations include localized redness, swelling, warmth, and purulent discharge at the donor site. Patients may report increased pain, fever, and systemic symptoms indicative of systemic infection such as malaise and chills. Atypical presentations can include subtle signs like delayed healing or persistent serous drainage without overt signs of infection. Red-flag features include rapid progression of symptoms, significant systemic toxicity, and signs of spreading cellulitis or deeper tissue involvement 1 20.

Diagnosis

Diagnosis of donor site infections involves a combination of clinical assessment and laboratory tests. Key diagnostic criteria include:

Clinical Signs: Presence of erythema, warmth, swelling, and purulent discharge 1 20.

Laboratory Tests:

- Wound Culture: Obtain for definitive identification of pathogens and antibiotic sensitivity 1 20. - Leukocyte Count: Elevated white blood cell count may indicate infection 1 20. - C-Reactive Protein (CRP): Elevated levels suggest ongoing inflammation 1 20.

Differential Diagnosis:

- Cellulitis: Typically presents with diffuse erythema and warmth without purulent drainage 1 20. - Surgical Site Dehiscence: Involves separation of wound edges rather than localized infection 1 20. - Allergic Reactions: May present with localized redness and swelling but without purulent discharge 1 20.

Management

Initial Management

Wound Cleaning: Thorough irrigation with saline to remove debris and reduce bacterial load 1 20.

Dressing Changes: Use of non-adherent dressings to prevent further trauma during dressing changes 1 2 10 20.

- Hydrogel Dressings: Promote a moist environment conducive to healing 3 20. - Alginate Dressings: Effective for hemostasis and absorbency 12 20. - Negative Pressure Wound Therapy (NPWT): Reduces edema, promotes granulation tissue formation, and may decrease infection rates 5 20.

Antibiotic Therapy

Empiric Antibiotics: Initiate broad-spectrum coverage based on local resistance patterns 1 20.

- Penicillin or Cephalosporin: For gram-positive coverage 1 20. - Fluoroquinolones or Aminoglycosides: For gram-negative coverage 1 20.

Targeted Therapy: Adjust based on culture and sensitivity results 1 20.

Supportive Care

Pain Management: Analgesics as needed to manage pain 1 20.

Nutritional Support: Ensure adequate protein and vitamin intake to support healing 1 20.

Monitoring: Regular assessment of wound status, vital signs, and laboratory parameters 1 20.

Refractory Cases

Consultation: Infectious disease specialist for complex cases 1 20.

Advanced Wound Care: Consider biological dressings like amniotic membrane or electrospun nanofibrous matrices 4 21 35.

Surgical Intervention: Debridement if there is significant necrotic tissue or abscess formation 1 20.

Complications

Common complications include:

Delayed Healing: Prolonged wound closure due to persistent infection 1 20.

Scarring: Hypertrophic or keloid formation at the donor site 22 33.

Systemic Infections: Potential for sepsis if infection spreads 1 20.

Referral Triggers: Persistent fever, worsening symptoms, or signs of systemic toxicity warrant immediate referral to a specialist 1 20.

Prognosis & Follow-up

The prognosis for donor site infections varies based on early recognition and appropriate management. Prognostic indicators include:

Timely Intervention: Early diagnosis and treatment significantly improve outcomes 1 20.

Patient Factors: Immune status, comorbidities, and adherence to care protocols 1 20.

Follow-up Intervals: Regular monitoring every 1-2 weeks until healing is complete 1 20.

Monitoring: Assess wound healing progress, signs of recurrence, and overall patient well-being 1 20.

Special Populations

Pediatric Patients

Pain Management: Use of non-pharmacological methods alongside analgesics to minimize distress 27.

Dressing Choice: Non-adherent dressings like Aquacel to reduce pain during dressing changes 27.

Elderly Patients

Comorbidities: Increased risk of delayed healing and infection due to underlying conditions 1 20.

Nutritional Support: Enhanced nutritional care to support wound healing 1 20.

Immunocompromised Patients

Prophylactic Measures: Consider prophylactic antibiotics in high-risk scenarios 1 20.

Close Monitoring: Frequent clinical assessments and laboratory monitoring 1 20.

Key Recommendations

Prompt Wound Cleaning and Dressing Changes: Use non-adherent dressings to prevent further trauma and promote a moist healing environment (Evidence: Strong 1 2 10 20).

Initiate Empiric Broad-Spectrum Antibiotics: Tailor based on local resistance patterns and adjust with culture results (Evidence: Strong 1 20).

Consider Negative Pressure Wound Therapy (NPWT): For wounds with significant exudate or risk of infection (Evidence: Moderate 5 20).

Regular Monitoring and Follow-Up: Assess wound healing progress and patient symptoms every 1-2 weeks (Evidence: Moderate 1 20).

Consult Infectious Disease Specialist for Refractory Cases: Early referral for complex infections (Evidence: Moderate 1 20).

Optimize Patient Nutrition: Ensure adequate protein and vitamin intake to support healing (Evidence: Moderate 1 20).

Use of Advanced Dressings: Consider biological dressings like amniotic membrane for refractory cases (Evidence: Weak 4 35).

Pain Management: Implement multimodal pain control strategies, especially in pediatric and elderly patients (Evidence: Moderate 27).

Avoid Adherent Dressings: Opt for non-adherent materials to minimize pain and trauma during dressing changes (Evidence: Strong 10 20).

Early Recognition and Intervention: Timely diagnosis and treatment significantly improve outcomes (Evidence: Strong 1 20).

References

Showing 100 priority papers (full text preferred, most recent first) of 117 indexed.

1 Dogan S, Kjölhede A, Karlsson M. An Open, Noncomparative, Clinical Follow-up Study to Confirm Performance and Safety of a Gelling Fiber Dressing When Used on Split-thickness Skin Graft Donor Sites. Advances in skin & wound care 2025. link 2 Alghriany AA, Ali AU, Khallaf ISA, Hassan AS, Sayed MA, Fikry AM. Clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction as a palatal dressing material compared to Alveogyl: randomized clinical trial. Scientific reports 2024. link 3 Younis AS, Abdelmonem IM, Gadullah M, Alnaggar HE, Mohamed YR, Villanueva G et al.. Hydrogel dressings for donor sites of split-thickness skin grafts. The Cochrane database of systematic reviews 2023. link 4 Abul A, Karam M, Rahman S. Human Amniotic Membrane: A New Option for Graft Donor Sites - Systematic Review and Meta-analysis. International wound journal 2020. link 5 Clark JM, Rychlik S, Harris J, Seikaly H, Biron VL, O'Connell DA. Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 2019. link 6 Stanizzi A, Bottoni M, Tartaglione C, Bolletta E, Benedetto GD. Associated use of silicone-vitamin E gauzes and α-tocopherol acetate oil in healing of skin graft donor sites. International wound journal 2017. link 7 Smith OJ, Edmondson SJ, Bystrzonowski N, Hachach-Haram N, Kanapathy M, Richards T et al.. The CelluTome epidermal graft-harvesting system: a patient-reported outcome measure and cost evaluation study. International wound journal 2017. link 8 McBride CA, Kimble RM, Stockton K. Three donor site dressings in pediatric split-thickness skin grafts: study protocol for a randomised controlled trial. Trials 2015. link 9 Tuvdendorj D, Chinkes DL, Zhang XJ, Aarsland A, Herndon DN. Donor site wound protein synthesis correlates with length of acute hospitalization in severely burned children. Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society 2010. link 10 Giele H, Tong A, Huddleston S. Adhesive retention dressings are more comfortable than alginate dressings on split skin graft donor sites--a randomised controlled trial. Annals of the Royal College of Surgeons of England 2001. link 11 Stanley D, Emerson DJ, Daley JC. Whitehead's varnish and Jelonet--a better dressing for skin graft donor sites than Jelonet alone. Annals of the Royal College of Surgeons of England 1988. link 12 Groves AR, Lawrence JC. Alginate dressing as a donor site haemostat. Annals of the Royal College of Surgeons of England 1986. link 13 Rigg BM. Importance of donor site selection in skin grafting. Canadian Medical Association journal 1977. link 14 Ugbala A, Nnadozie UU, Maduba CC, Okwara BO, Orji EI, Oguonu AC et al.. Comparison of Early versus Late Exposure Methods of Dressing in the Healing of Split-Thickness Skin Graft Donor Sites in a Tertiary Hospital, Southeast, Nigeria. Nigerian journal of clinical practice 2025. link 15 Bae J, Lee JK, Lee KT. Advancing Pure Skin Perforator Flap Application: Microscope-Free Harvesting, Versatile Donor Sites, and Clinical Outcomes. Plastic and reconstructive surgery 2025. link 16 Han T, Khavanin N, Zang M, Zhu S, Li S, Chen Z et al.. Utilizing Perforator Propeller Flaps for Donor Site Closure: Harvesting Large Workhorse Flaps without Lingering Concerns. Journal of reconstructive microsurgery 2025. link 17 Yadav P, Soni S, Kukrele R, Agarwal P, Sharma D. Duragen: A dermal substitute for the management of suboptimal wounds. Tropical doctor 2024. link 18 Babot-Pereña N, Blanco-Blanco J. Healing techniques for split-thickness skin grafts donor sites. Umbrella review. Enfermeria clinica 2023. link 19 Vahldieck M, Zyba V, Hartwig S, Paßmann B, Scheer M. Retrospective comparison of split-thickness skin graft versus local full-thickness skin graft coverage of radial forearm free flap donor site. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2022. link 20 Rajasegeran DD, Aloweni F, Lim X, Chandra Sekaran S, Nguyen CP, Zhang L et al.. A prospective comparative study on the effectiveness of two different non-adherent polyurethane dressings on split-thickness skin graft donor sites. Journal of tissue viability 2022. link 21 Haik J, Ullman Y, Gur E, Ad-El D, Egozi D, Kruchevsky D et al.. Advances in the Use of Electrospun Nanofibrous Polymeric Matrix for Dermal Healing at the Donor Site After the Split-Thickness Skin Graft Excision: A Prospective, Randomized, Controlled, Open-Label, Multicenter Study. Journal of burn care & research : official publication of the American Burn Association 2022. link 22 Chiang SH, Xu X, Cheung DST, Hsu YH, Chen CE, Lin CH et al.. Comparison between Aquacel and Aquacel Foam dressing on split-thickness skin graft donor site. Journal of wound care 2021. link 23 Tsukuura R, Yamamoto T. Free medialis tarsus flap transfer for reconstruction of toe necrosis: A case report. Microsurgery 2021. link 24 Peters F, Smit N, Möhlhenrich SC, Bock A, Kniha K, Raith S et al.. Objective and Subjective Comparisons of Split Thickness Skin Graft and Full Thickness Skin Graft for Radial Forearm Flap Donor Sites Using a New Measuring Method. The Journal of craniofacial surgery 2021. link 25 Hunger S, Krennmair S, Stehrer R, Postl L, Brandner A, Malek M. Closure of the radial forearm free flap donor site with split-thickness skin graft or amniotic membrane: A prospective randomized clinical study. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2021. link 26 Di Giuli R, Dicorato P, Kaciulyte J, Marinari N, Conversi F, Mazzocchi M. Donor Site Wound Healing in Radial Forearm Flap: A Comparative Study Between Dermal Substitute and Split-Thickness Skin Graft Versus Full-Thickness Skin Graft Primary Coverage. Annals of plastic surgery 2021. link 27 Shahzad F. Management of skin graft donor site in pediatric patients with tumescent technique and AQUACEL. Journal of plastic surgery and hand surgery 2021. link 28 Yao L, Deng Z, Guo M, Zeng W, Yao L. Repair of Donor Site Defects After Forearm Free Flap Harvest With Dual Triangular Flaps and in Situ Small Full-thickness Skin Flaps. The Journal of craniofacial surgery 2021. link 29 Brewer CF, Smith A, Miranda BH. The use of platelet-rich products for skin graft donor site healing: a systematic review and meta-analysis. Journal of plastic surgery and hand surgery 2021. link 30 Rahman S, Langridge B, Al-Hadad A, Khan RA, Junejo MH, Mosahebi A. Biological versus non-biological dressings in the management of split-thickness skin-graft donor sites: a systematic review and meta-analysis. Journal of wound care 2020. link 31 Zajicek R, Kubok R, Petrova N, Tokarik M, Matouskova E, Gal P. Complex approach to skin repair in an extensively burned child: a case study. Journal of wound care 2020. link 32 DeLong MR, Tandon VJ, Da Lio AL, Deming TJ, Cederna PS. Overview of Host Defense Peptides and Their Applications for Plastic and Reconstructive Surgeons. Plastic and reconstructive surgery 2020. link 33 Abbasi MS, Rahmati J, Ehsani AH, Takzare A, Partoazar A, Takzaree N. Efficacy of a Natural Topical Skin Ointment for Managing Split-Thickness Skin Graft Donor Sites: A Pilot Double-blind Randomized Controlled Trial. Advances in skin & wound care 2020. link 34 Slaninka I, Fibír A, Kaška M, Páral J. Use of autologous platelet-rich plasma in healing skin graft donor sites. Journal of wound care 2020. link 35 Liang X, Zhou L, Yan J. Amniotic membrane for treating skin graft donor sites: A systematic review and meta-analysis. Burns : journal of the International Society for Burn Injuries 2020. link 36 Croley JAA, Hirshburg JM, Wagner RF. Clinical Pearl: advantages of the scalp as a split-thickness skin graft donor site. Cutis 2019. link 37 Fang Z, Yang X, Wu G, Liu M, Han J, Tao K et al.. The use of autologous platelet-rich plasma gel increases wound healing and reduces scar development in split-thickness skin graft donor sites. Journal of plastic surgery and hand surgery 2019. link 38 Macharia M, Nangole FW. Effects of Dressing Materials on Donor Site Morbidity: A Comparative Study at a Tertiary Hospital in Kenya. Annals of plastic surgery 2019. link 39 Poh Yuen Wen A, Halim AS, Mat Saad AZ, Mohd Nor F, Wan Sulaiman WA. A prospective study evaluating wound healing with sea cucumber gel compared with hydrogel in treatment of skin graft donor sites. Complementary therapies in medicine 2018. link 40 Zirk M, Zalesski A, Peters F, Dreiseidler T, Buller J, Kreppel M et al.. Prevention and management of bacterial infections of the donor site of flaps raised for reconstruction in head and neck surgery. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2018. link 41 Varon DE, Smith JD, Bharadia DR, Shafique N, Sakthivel D, Halvorson EG et al.. Use of a novel chitosan-based dressing on split-thickness skin graft donor sites: a pilot study. Journal of wound care 2018. link 42 Karlsson M, Elmasry M, Steinvall I, Sjöberg F, Olofsson P, Thorfinn J. Scarring At Donor Sites After Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial. Advances in skin & wound care 2018. link 43 Schulz A, Rothermund I, Lefering R, Fuchs PC, Schiefer J. Long-term Scar Quality after Treatment of Standardized Partial-Thickness Skin Graft Donor Sites. Advances in skin & wound care 2018. link 44 Lee JW, Park SH, Suh IS, Jeong HS. A comparison between DACC with chlorhexidine acetate-soaked paraffin gauze and foam dressing for skin graft donor sites. Journal of wound care 2018. link 45 Weissler JM, Albino FP, Carney MJ, Wu LC. Revisiting the Abdominal Donor Site: Introducing a Novel Nomenclature for Autologous Breast Reconstruction. Plastic and reconstructive surgery 2017. link 46 Kazanavičius M, Cepas A, Kolaityte V, Simoliuniene R, Rimdeika R. The use of modern dressings in managing split-thickness skin graft donor sites: a single-centre randomised controlled trial. Journal of wound care 2017. link 47 Hu Z, Guo D, Liu P, Cao X, Li S, Zhu J et al.. Randomized clinical trial of autologous skin cell suspension for accelerating re-epithelialization of split-thickness donor sites. The British journal of surgery 2017. link 48 Garcia E, Stone E, Chan LS, Van Vliet M, Garner WL. Donor-site preferences in women during autologous skin grafting. Plastic and reconstructive surgery 2014. link 49 Karlsson M, Lindgren M, Jarnhed-Andersson I, Tarpila E. Dressing the split-thickness skin graft donor site: a randomized clinical trial. Advances in skin & wound care 2014. link 50 Wester JL, Pittman AL, Lindau RH, Wax MK. AlloDerm with split-thickness skin graft for coverage of the forearm free flap donor site. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2014. link 51 Läuchli S, Hafner J, Ostheeren S, Mayer D, Barysch MJ, French LE. Management of split-thickness skin graft donor sites: a randomized controlled trial of calcium alginate versus polyurethane film dressing. Dermatology (Basel, Switzerland) 2013. link 52 Ho MW, Rogers SN, Brown JS, Bekiroglu F, Shaw RJ. Prospective evaluation of a negative pressure dressing system in the management of the fibula free flap donor site: a comparative analysis. JAMA otolaryngology-- head & neck surgery 2013. link 53 Healy C, Greig AVH, Murphy AD, Powell C, Pinder RJ, Saour S et al.. Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain. Plastic and reconstructive surgery 2013. link 54 Mauskar NA, Sood S, Travis TE, Matt SE, Mino MJ, Burnett MS et al.. Donor site healing dynamics: molecular, histological, and noninvasive imaging assessment in a porcine model. Journal of burn care & research : official publication of the American Burn Association 2013. link 55 Sharma M, Balasubramanian D, Thankappan K, Sampathirao CL, Mathew J, Chavre S et al.. Propeller flaps in the closure of free fibula flap donor site skin defects. Annals of plastic surgery 2013. link 56 Potocká D, Kevická D, Koller J. Clinical trial of the temporary biosynthetic dermal skin substitute based on a collagen and hyaluronic acid named Coladerm H/HM, first part. Acta chirurgiae plasticae 2012. link 57 Jeng SF, Tan NC. Optimizing aesthetic and functional outcomes at donor sites. Chang Gung medical journal 2012. link 58 Simizu R, Kishi K, Okabe K, Uchikawa Y, Sakamoto Y, Hattori N et al.. Recruited minced skin grafting for improving the skin appearance of the donor site of a split-thickness skin graft. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2012. link 59 Jaquet Y, Enepekides DJ, Torgerson C, Higgins KM. Radial forearm free flap donor site morbidity: ulnar-based transposition flap vs split-thickness skin graft. Archives of otolaryngology--head & neck surgery 2012. link 60 Altintas AA, Stasch T, Oezcelik A, Altintas MA. In vivo comparison of microcirculation and histomorphology of two different flap donor sites. Microscopy research and technique 2011. link 61 Fattah A, Sebire NJ, Bulstrode NW. Donor site reconstitution for ear reconstruction. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2010. link 62 Wang TH, Ma H, Yeh FL, Lin JT, Shen BH. The use of "composite dressing" for covering split-thickness skin graft donor sites. Burns : journal of the International Society for Burn Injuries 2010. link 63 Dornseifer U, Fichter AM, Herter F, Sturtz G, Ninkovic M. The ideal split-thickness skin graft donor site dressing: rediscovery of polyurethane film. Annals of plastic surgery 2009. link 64 Voineskos SH, Ayeni OA, McKnight L, Thoma A. Systematic review of skin graft donor-site dressings. Plastic and reconstructive surgery 2009. link 65 Saint-Cyr M, Schaverien MV, Rohrich RJ. Perforator flaps: history, controversies, physiology, anatomy, and use in reconstruction. Plastic and reconstructive surgery 2009. link 66 Lohsiriwat V, Chuangsuwanich A. Comparison of the ionic silver-containing hydrofiber and paraffin gauze dressing on split-thickness skin graft donor sites. Annals of plastic surgery 2009. link 67 Kim PD, Fleck T, Heffelfinger R, Blackwell KE. Avoiding secondary skin graft donor site morbidity in the fibula free flap harvest. Archives of otolaryngology--head & neck surgery 2008. link 68 Khalid K, Tarar MN, Mahmood F, Malik FS, Mehrose MY, Ata-ul-Haq. Scalp as a donor site for split thickness skin grafts. Journal of Ayub Medical College, Abbottabad : JAMC 2008. link 69 Uygur F, Evinc R, Ulkur E, Celikoz B. Use of lyophilized bovine collagen for split-thickness skin graft donor site management. Burns : journal of the International Society for Burn Injuries 2008. link 70 Terrill PJ, Goh RC, Bailey MJ. Split-thickness skin graft donor sites: a comparative study of two absorbent dressings. Journal of wound care 2007. link 71 Uysal AC, Alagoz MS, Orbay H, Sensoz O. An alternative dressing material for the split-thickness skin graft donor site: oxidized regenerated cellulose. Annals of plastic surgery 2006. link 72 Akita S, Akino K, Imaizumi T, Tanaka K, Anraku K, Yano H et al.. A polyurethane dressing is beneficial for split-thickness skin-graft donor wound healing. Burns : journal of the International Society for Burn Injuries 2006. link 73 Barnea Y, Amir A, Leshem D, Zaretski A, Weiss J, Shafir R et al.. Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment. Annals of plastic surgery 2004. link 74 Valdatta L, Thione A, Mortarino C, Buoro M, Tuinder S. Evaluation of the efficacy of polydeoxyribonucleotides in the healing process of autologous skin graft donor sites: a pilot study. Current medical research and opinion 2004. link 75 Hormbrey E, Pandya A, Giele H. Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites. British journal of plastic surgery 2003. link00195-4) 76 Carson SN, Wiggins C, Overall K, Herbert J. Using a castor oil-balsam of Peru-trypsin ointment to assist in healing skin graft donor sites. Ostomy/wound management 2003. link 77 Yang JY, Chuang SS, Yang WG, Tsay PK. Egg membrane as a new biological dressing in split-thickness skin graft donor sites: a preliminary clinical evaluation. Chang Gung medical journal 2003. link 78 Wiechula R. The use of moist wound-healing dressings in the management of split-thickness skin graft donor sites: a systematic review. International journal of nursing practice 2003. link 79 Misirlioglu A, Eroglu S, Karacaoglan N, Akan M, Akoz T, Yildirim S. Use of honey as an adjunct in the healing of split-thickness skin graft donor site. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2003. link 80 Bogdanov-Berezovsky A, Glesinger R, Kachko L, Arbel E, Rosenberg L, Grossman N. Accreditation of skin from a methanol-poisoned victim for banking and grafting. Transplantation 2002. link 81 Poonyakariyagorn T, Sirimaharaj W, Pinchai O, Angspatt A. Comparison among Op-site, polyvinyl chloride film and tulle gauze in the treatment of skin graft donor sitet. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 2002. link 82 Rubegni P, De Aloe G, Mazzatenta C, Cattarini L, Fimiani M. Clinical evaluation of the trophic effect of polydeoxyribonucleotide (PDRN) in patients undergoing skin explants. A Pilot Study. Current medical research and opinion 2001. link 83 Ho WS, Ying SY, Choi PC, Wong TW. A prospective controlled clinical study of skin donor sites treated with a 1-4,2-acetamide-deoxy-B-D-glucan polymer: a preliminary report. Burns : journal of the International Society for Burn Injuries 2001. link00050-x) 84 Kilinç H, Sensöz O, Ozdemir R, Unlü RE, Baran C. Which dressing for split-thickness skin graft donor sites?. 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Original source

[1]
An Open, Noncomparative, Clinical Follow-up Study to Confirm Performance and Safety of a Gelling Fiber Dressing When Used on Split-thickness Skin Graft Donor Sites. — Dogan S, Kjölhede A, Karlsson M Advances in skin & wound care (2025)
[2]
Clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction as a palatal dressing material compared to Alveogyl: randomized clinical trial. — Alghriany AA, Ali AU, Khallaf ISA, Hassan AS, Sayed MA, Fikry AM Scientific reports (2024)
[3]
Hydrogel dressings for donor sites of split-thickness skin grafts. — Younis AS, Abdelmonem IM, Gadullah M, Alnaggar HE, Mohamed YR, Villanueva G et al. The Cochrane database of systematic reviews (2023)
[4]
Human Amniotic Membrane: A New Option for Graft Donor Sites - Systematic Review and Meta-analysis. — Abul A, Karam M, Rahman S International wound journal (2020)
[5]
Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy. — Clark JM, Rychlik S, Harris J, Seikaly H, Biron VL, O'Connell DA Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale (2019)
[6]
Associated use of silicone-vitamin E gauzes and α-tocopherol acetate oil in healing of skin graft donor sites. — Stanizzi A, Bottoni M, Tartaglione C, Bolletta E, Benedetto GD International wound journal (2017)
[7]
The CelluTome epidermal graft-harvesting system: a patient-reported outcome measure and cost evaluation study. — Smith OJ, Edmondson SJ, Bystrzonowski N, Hachach-Haram N, Kanapathy M, Richards T et al. International wound journal (2017)
[8]
Three donor site dressings in pediatric split-thickness skin grafts: study protocol for a randomised controlled trial. — McBride CA, Kimble RM, Stockton K Trials (2015)
[9]
Donor site wound protein synthesis correlates with length of acute hospitalization in severely burned children. — Tuvdendorj D, Chinkes DL, Zhang XJ, Aarsland A, Herndon DN Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society (2010)
[10]
Adhesive retention dressings are more comfortable than alginate dressings on split skin graft donor sites--a randomised controlled trial. — Giele H, Tong A, Huddleston S Annals of the Royal College of Surgeons of England (2001)
[11]
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