2. Re-used Donor Sites

In patients with large burns, donor sites once healed are often reused to cover remaining burn. Less and less dermis remains in the wound and a delayed healing process often with scarring will occur. Rebuilding the dermal component with a wound matrix should significantly increase the healing rate and decrease scarring in reused donor site areas.

A number of dressings are typically used on donor sites.  Fine mesh or grease gauze is porous and allows the initial bleeding to exit from the wound surface as well as the exit of blood and plasma that leak during the postoperative period.  Gauze, however, is not flexible and is not sufficiently occlusive to control pain.  In fact, ambulation or motion is very difficult with donor sites covered with these dressings.  In addition, there are minimal to no antibacterial properties, increasing the potential for infection if nearly open burn wounds are present.

Alternative dressings include biobrane or polyurethane dressing such as Opsite.  These dressings will provide a seal, thereby eliminating the risk of external infection as well as diminishing pain.   In addition, these dressings have no pro-healing properties. 

Tissue Engineered Wound Matrix Coverage of a Donor Site

The advantage of the use of Wound Matrix dressing is that the dermis lost with the STSG is replaced with Wound Matrix as it incorporates.  The Tissue Engineered Wound Matrix also contains all the active proteins and matrix components of dermis which can increase the rate of re-epithelialization.  In addition, the use of a  wound matrix results in immediate wound closure thereby protecting the remaining dermis.

Figure 3: Grease Gauze Donor Site Dressing (typical)

Figure 4: Skin Substitute Dressing

Figure 5: Donor Site covered with OASIS followed by Secondary Dressing

Figure 6: OASIS Wound Matrix on Donor Site

Figure 7: OASIS Wound Matrix on Donor Site day 3