The Efficacy of Chitosan Dressing in Reducing Blood Loss for Harvest Site in Split Thickness Skin Graft: A Randomized Control Trial
Thitinut Dilokhuttakarn MD*, Parunyu Vilai MD*, Visit Rungsinaporn MD*
Affiliation : * Department of Orthopaedics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Background : Split thickness skin grafting (STSG) is common procedure for covering soft tissue defects and causes bleeding
due to large raw surface area. Chitosan is a biodegradable, non-toxic, complex carbohydrate derivative extracted from chitin
found in the shells of crustaceous animals. Chitosan is a new local hemostatic dressing certified for external use. But there was
no study which was conducted in the randomized control trial to prove the efficacy of chitosan in reducing blood loss for
harvest site in split thickness skin graft.
Objective : To compare the efficacy of chitosan dressing and standard dressings in reducing blood loss at STSG harvest site
and observe its complications.
Material and Method: A randomized control trial study to compare the efficacy of chitosan dressing and standard dressings
in reducing blood loss at STSG harvest site was performed between June 2014 to August 2015 at HRH Princess Maha Chakri
Sirindhorn Medical Center, Srinakharinwirot University in Nakhon Nayok province. Demographic data, area of harvest site,
blood loss, VAS score at the time of wound dressing and complications were recorded.
Results : Twenty patients with skin defect were randomly assigned into 2 groups (Chitosan group n = 10 and Standard
dressing group n = 10). No difference of demographic data between the 2 groups. The average area of donor site in the
chitosan group was 36.5 cm2 and standard dressing group was 40.2 cm2 (p-value = 0.42). Blood loss from the chitosan group
was 15.4 gm compared with 26.3 gm from the standard group (p-value = 0.81). Even though chitosan dressing can decrease
the amount bleeding by 40% compared to the standard dressing but there was no significant difference between the two
groups. No serious complication was detected at the time of follow-up.
Conclusion : Chitosan gauze dressing did not decrease blood loss from harvest sites of STSG compared with the standard
dressing group and there was no serious complication associated with chitosan was detected.
Keywords : Skin graft, Dressing technique, Chitosan
