Improved Healing of Split Thickness Skin Graft Donor Sites

Cosmetically unacceptable pigmentation changes and hypertrophic scarring often complicate split thickness skin graft (STSG) donor sites. In fact, patients often ask about other alternatives when confronted with the need to harvest STSG, particularly because they fear additional disfigurement. Because recent evidence suggests that a moist environment promotes more optimal healing, we conducted a limited controlled and comparative study to assess the effect of a newly introduced burn ointment MEBO (Moist Exposed Burn Ointment) (Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE) on re-epithelialization and healing of STSG donor sites as compared with the conventional Sofra-Tulle semi-open dressing (Roussel Laboratories Ltd., Uxbridge, England). We observed that MEBO treated areas were completely reepithelialized within 5 to 6 days while conventionally treated areas required 10 to 12 days to heal. Conventionally treated areas were also less hyperemic and less pigmented. Photographs from both treatment groups were retrospectively evaluated along a defined assessment scale; these also revealed significantly better cosmetic results for ointment treated areas. The most striking difference in our opinion, however, was the lack of epidermal sliding in the MEBO treated areas. This result is similar to normal skin and suggests a profound structural difference for MEBO-induced healing. The epidermis of the basal layer in the MEBO treated areas seemed to be better anchored to the underlying dermis, theoretically making MEBO treated areas less vulnerable to frictional forces. These study results imply that the application of MEBO will result in equally good re-epithelialization for similar partial thickness cutaneous wounds caused by dermabraision, chemical peeling, or laser treatment for skin resurfacing.