Split thickness skin grafting (STSG) is a frequently used technique for covering soft tissue and skin defects. Its wide range of applications makes it valuable not only to plastic and reconstructive surgeons but also to other surgical specialties.

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) 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.

Although statistical analysis was not performed because of the small number of patients in each group, we can report that MEBO treated areas were completely re-epithelialized within 5 to 6 days, whereas the conventionally treated areas required 10 to 12 days to heal. 

The MEBO treated areas were also markedly less hyperemic and less pigmented. 

Final cosmetic appearance and patient satisfaction were also higher for MEBO treated areas. 

Finally, the retrospective image assessment scores were also better for the MEBO treated areas (Figure 1). Differences in pain assessment, however, were less marked. This is probably because MEBO was not applied every 6 hours as is recommended to achieve optimal analgesia. 

Nevertheless, all patients were noted to be more comfortable with MEBO, probably because of its rapid healing time and therefore shorter painful period. In one adult male patient, hair regrowth proceeded at a faster rate in the MEBO treated area than in the control area. Finally, all patients showed a lack of epidermal sliding in the MEBO treated area that was comparable to normal skin. Variable degrees of epidermal sliding was seen in control areas.

The epidermis of the basal layer in the MEBO treated group seemed to be better anchored to the underlying dermis, which makes MEBO treated areas theoretically less vulnerable to frictional forces.17,18

Full Report: Improved Healing of Split Thickness Skin Graft Donor Sites, The journal of Applied Research 2002; 2: 6-9