Cutaneous
scarring observed in
wounds is, to a significant degree, dependent upon the time it takes for the
wounds to heal. Various topical dressings are proposed to influence healing time in donor sites. In this prospective randomized study, we examined the effect of
Vaseline gauze (VD; Branolind, Paul Hartmann AG, Germany),
Biobrane (BD; Bertek Pharmaceuticals, Inc., Morgantown, WV), an occlusive film dressing Barrier Flex (OD; Moelnlycke Health Care GmbH, Germany), and an equine
collagen foil, Tissu Foil E (CD; Baxter, Heidelberg, Germany), on re-epithelialization and
scarring in standardized donor site
wounds. At 6 months after surgery, donor site
scars and normal uninjured mirror sided skin were evaluated in 33 patients using both the Vancouver
Scar Scale (VSS) and the cutometer SEM 575 (Courage and Khazaka). The median healing time for OD was 14 days, BD 16 days, CD 19 days, and VD 19 days. The single parameter pliability of the VSS was not significantly different from uninjured skin when all donor site
scars were pooled. No difference was found between the four groups. Viscoelastic analysis of all pooled patient data showed a significant difference for Uf (total deformation), Ua (total recovery), Ur (immediate retraction), Ue (immediate distension), Ur/Ue, and Ur/Uf, indicating that donor sites significantly differed from normal uninjured skin. No significant correlation between objective viscoelastic measurements and the subjective pliability assessment of the VSS was found. Viscoelastic differences were greatest in the VD and BD groups. Viscolelastic differences did not significantly correlate with healing time. Various
wound dressings had minimal yet significant influence on healing time and
scarring. In contrast to the VSS, viscoelastic measurements of skin pliability can objectify
scarring when few differences are anticipated.