Usefulness of Silicone Net Dressing in Fixation of Skin Grafts

PURPOSE: Skin graft may fail for a number of reasons. Hematoma or seroma formation prevents graft adherence. Traditionally tie-over dressing has been used in skin graft fixation, but skin graft in convex and narrow place like fingers or toes, tie-over dressing is hard to be applied. And Vaseline gauze over graft often adheres to graft by exudate into gauze fibers and hardening, and may cause damage to graft in dressing change. We report successful results of using silicone net dressing in fixation of split thickness skin graft over these place. METHODS: After skin graft, the silicone net, Mepitel(R) (Molnlycke Health Care, Box 13080, SE-402 52 Goteborg, Sweden) was applied over the graft followed saline wet gauze dressing in 25 patients. 13 cases were on finger, 8 cases were on foot or toes, 4 cases were on anterior chest. RESULTS: In 22 cases, there were no hematoma or seroma formation, Mepitel(R) maintained 5 days after skin graft. And then, Mepitel(R) was removed from the graft. In 3 cases, there were hematoma formation, Mepitel(R) was removed at 3 days after skin graft. In all cases, grafts were taken well without maceration or skin eruption. CONCLUSION: The silicone net, Mepitel(R), is dressing material made of silicone gel bound to a pliable polyamide net, and it can provide uniform pressure to the graft, even in convex and narrow place. And net like structure allows the exudates of the wound to pass freely into the secondary absorbent dressing and easier to remove from the grafts than Vaseline gauze. We think that the use of a Mepitel(R) is a efficient tool for securing skin grafts.

Efficacy of Mepitel(R) in Treatment of Second Degree Burn

PURPOSE: The last decade has focused on healing as the major outcome of burn management with little attention paid to other important patient-centered outcomes, such as pain. Traditional standard dressings using silver sulfadiazine cream and vaseline gauze may result in significant pain at dressing change, wound dryness, increase necessity for dressing change, and also traumatizing the skin and wound bed. In this paper we introduce Mepitel(R), a new silicone dressing material showing satisfactory result than previous traditional standard dressings in burn dressing. METHODS: We conducted a prospective, observational study of 15 adult patients with second degree burn. At the arrive, we initially applied Mepitel(R) after bullae aspiration and changed the cover dressing depending on the degree of exudate from burn while still applying Mepitel(R) for 3 days. After dressing change, pain intensity was measured on an 11-point numeric rating scale. RESULTS: Mean time to wound reepithelization was 10.2 days and mean pain scores on a 11-point scale associated with dressing changes was 5.2 while requiring 0.5 intravenous narcotic administrations per dressing change. CONCLUSION: Mepitel(R) is a new grid like silicone coated nylon dressing containing no additional biologic compounds. The advantages of the Mepitel(R) are easy of use, non-adhesion to the wound, very good tolerance, keep moisture of wound and absence of pain during dressing change. This product has been used in our clinics and this paper serves as a report on our experiences with it.

The Wound Healing Effect of a Porous Silicone Dressing Material (Mepitel(R)) on Full Thickness Skin Defect of the Rat

PURPOSE: Mepitel(R) is a porous silicone dressing material which allows exudate to pass into an outer absorbent dressing and prevents the outer dressing from sticking to the wound. We compared the effects of Mepitel(R) to the standard vaseline gauze dressing on full thickness skin defect of the rat. METHODS: Two full thickness skin defects in rats (n=12) were developed on the back and applied Mepitel(R) on one defect and vaseline gauze on the other. Wound sizes, histologic findings and eletron microscopic findings were evaluated. RESULTS: The wound size of Mepitel(R) group decreased faster than vaseline gauze group with statistically significant difference during whole experimental period. In histolotic findings, Mepitel(R) group showed more epithelialization and granulation tissue formation and less inflammatory cell infiltration and necrosis than vaseline gauze group with statistically significant differences on scores (p=0.014 (at 1 week), 0.042 (at 2 weeks)). Electron microscopic findings supported histologic observation that Mepitel(R) dressing had rapid wound healing effects than vaseline gauze dressing. CONCLUSION: The dressing using Mepitel(R) prevents wound damage whenever changing dressings and protects newly formed tissue, therefore provides better wound healing effect compared to the vaseline gauze dressing.