Treatment of donor wounds with a free transplant grafts in children

Abstract

The biggest advantage of the medium thickness free grafts transplantation is that large areas of skin can be transplanted without any damage (functional or cosmetic) to the donor site wounds. However, for the implementation of this basic advantage in practice, is a smooth donor wound healing, which is most successful ensured by an appropriate treatment and by leaving the wound open. In the Children's Republican Hospital "Em.Cotaga" in Bums Department, during the 2009 have been hospitalized 626 patients. 114 patients of those operated, with diagnosis autodermoplasty with split grafts. The excision of the flap was carried out under general anesthesia. Before the excision, donor site was treated with antiseptic solution. Subcutaneously saline solution was injected till the formation of "citric peel". After this, the excision of the graft was performed. At the end of the operation to the surface of donor wound was covered with Kollahit, non-woven wound coverings based on collagen-chitosan complex. Coverage Kollahit is plased on the wound so that it stood for the wound for 5-10 mm, is pressed to the bottom of the wound, and then is imposed a gauze and fixed with gauze bandage. Donor site wound is immobilized. Bandages should be changed in two days after surgery. From the wound surface only the wet areas are re-moved and are replaced with new pieces of cover of the same size. The crust formed is closely welded to the bottom of the wound, forming a solid and yet flexible protective coating. Cover stucked to the wound are left on the wound until its complete epithelialization. Wound surface of the donor site wound epithelialization begins primarily from the edges. The development of the process of epithelialization is shown by the delamination of crust edges, which is observed in 6-8 days after the surgery. The lifted crust edges should be cut every day, so that they could not accidentally be caught on the patient’s clothes, and lift the adhered parts, which may cause bleeding and even lead to the occurrence of the infection. 10-14 days after the operation, the epithelialization ends, the crust is definitively decaled; the place of the donor site is shown only by the bright spot on the skin.The Kollahit coatings stimulate regeneration of damaged tissues in the wound: stimulate marginal and island epithelization and provide conditions to epithelial cells migration, providing the conditions for scar free healing. A very valuable asset of Kollahit is its: soft spongy structure, high capacity to absorb wound fluid content, the ability to provide normal moisture in the wound. This allows an easy and painless bandage change. Due to the high plasticity,Kollahit makes it easy to make coatings for various parts of the body. They possess wound-healing, antimicrobial and analgesic effect.