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Management of skin-grafted burn wounds with Xeroform and layers of dry coarse-mesh gauze dressing results in excellent graft take and minimal nursing time.

Abstract
The goals of postoperative treatment for split-thickness skin grafts (STSGs) are to maintain graft integrity, prevent graft and wound desiccation, and minimize infections. As we documented in a telephone survey of 16 burn centers, dressings for skin grafts usually consist of multiple layers of coarse-mesh gauze; the dressings receive frequent applications of aqueous solutions that contain antimicrobial agents to control bacterial growth and to maintain a moist environment at the wound surface. We prospectively studied the efficacy of our standard dressing of one layer of Xeroform (Kendall Inc., Mansfield, Mass.), which consists of fine-mesh gauze impregnated with bismuth tribromophenate, applied to the STSG surface followed by layers of dry gauze dressings wrapped in Kerlix (Kendall Inc.); the entire dressings were left intact until postoperative day 5. We evaluated 142 STSGs on 100 patients, mean age 29.2 years (range 0.3 to 79 years), with burns of 0.5% to 60% total body surface area (mean 9.1%). Meshed or sheet STSGs of 0.5% to 18% total body surface area (mean 3.14%) were placed on deep partial- or full-thickness excised wounds. Xeroform, followed by coarse-mesh gauze dressing, was applied after skin grafts were completed. The entire dressing was left intact until the initial takedown-to-graft at 5 days. Patients' grafts were evaluated on postoperative day 5 for the percentage of "take" and subgraft fluid collected; this evaluation was then repeated every other day for 10 days. On postoperative day 5 evaluations, mean skin graft take in all patients was 98.54% +/- 0.72%. Xeroform and coarse-mesh gauze dressings used to cover STSGs and left intact for 5 days until the initial dressing change, resulted in highly successful graft outcomes, with minimal postoperative nursing care compared with other dressing methods for skin grafts.
AuthorsW Hansbrough, C Doré, J F Hansbrough
JournalThe Journal of burn care & rehabilitation (J Burn Care Rehabil) 1995 Sep-Oct Vol. 16 Issue 5 Pg. 531-4 ISSN: 0273-8481 [Print] United States
PMID8537426 (Publication Type: Journal Article)
Chemical References
  • Anti-Infective Agents, Local
  • Phenols
  • 2,4,6-tribromophenol
Topics
  • Adolescent
  • Adult
  • Aged
  • Anti-Infective Agents, Local
  • Bandages
  • Burns (nursing, therapy)
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Phenols
  • Postoperative Care
  • Prospective Studies
  • Skin Transplantation (nursing)
  • Treatment Outcome
  • Wound Healing (physiology)

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