Wound Dressing Guidance

Xpansion skin graft mincer

Recommended Wound Dressing & Post-Operative Care Protocol

After the autograft procedure is performed, it is critical that the wound be kept moist to ensure the graft takes.
The following dressing protocol should be followed:

1. First apply a non-adherent interface dressing (e.g., bridal veil or Mepitel®). No petroleum-based products should be used on the wound contact layer. 2. Next apply a foam dressing that has a layer of hydrogel applied to its surface, which will be in contact with the contact dressing.
 
3.The foam is held in place with adhesive. (Mepilex® Border, Optifoam®, Allevyn® Border) 4.Finally the outer wrap is applied, typically a Kerlix gauze wrap. Compression and immobilization complete the dressing.
 
Skin micrograft dressing application

Note: Negative Pressure Wound Therapy (NPWT) may be used as a wound covering.  If NPWT is selected as a wound dressing, Tegaderm Contact MUST be used as an interface layer to avoid the disturbance of the micrografts. The hydrogel is not applied when using NPWT.

The donor site should be covered with a similar moist dressing using a hydrogel.

Patient Instructions

If the wound is on the lower extremity, patient must keep leg elevated at all times except for 5 min every hour for personal care during the 1st week. During the 2nd week, 10 min per hour is acceptable. On the 3rd week the patient should resume normal ambulation with a compressive wrap. If the wound is elsewhere on the body, there is no limitation to activity.

The first dressing change should be performed 5-7 days post grafting procedure.

  • 1 Leave interface layer in place and change foam
  • 2 Re-apply hydrogel on top of interface layer
  • 3 Replace foam and re-wrap

Special Note about Negative Pressure Wound Therapy

Negative pressure is acceptable as long as the pore size of the interface layer is small enough to prevent the 0.8mm x 0.8mm grafts from being pulled through the dressing. Negative pressure without a contact layer must be strictly avoided.

Normlgel®, Mepitel®, and Mepilex® Border are registered trademarks of Mölnlycke Health Care.

Tegaderm™ Hydrogel and Tegaderm™ Contact are trademarks of 3M.

Surgilube® is a registered trademark of Savage Laboratories, a division of Fougera Pharmaceuticals Inc.

Adaptic® is a registered trademark of Systagenix.

Optifoam® is a registered trademark of Medline Industries.

Allevyn® Border is a registered trademark of Smith & Nephew.

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