Xpansion Micro-Autografting Kit Wound dressing
After the autograft procedure is performed, it is critical that the wound be kept moist to ensure the graft takes. A firm dressing is also required to prevent graft movement. The following dressing protocol should be followed:
- First apply a non-adherent interface dressing over the micrografts (e.g. Mepitel®, Adaptic®, N-Terface®, Tegaderm Contact®, Jelonet® or Bactigras®).
- Apply a 2mm thick layer of a hydrogel or .1% Gentamicin cream to keep the grafts moist.
- Next apply an occlusive foam dressing that will help retain the moisture. (e.g. Mepilex® Border, Optifoam®, Allevyn®Border). If the foam dressing does not have a sufficient adhesive border, ensure it is held in place with extra adhesive tape.
- Finally the graft must be completely immobilised with a fixation dressing and the extremity wrapped with an elastic bandage. If the graft is near a joint then splinting or bracing is recommended.
The Donor site should also be covered in a similar moist dressing.
Negative Pressure Wound Therapy
Negative pressure is ideal as a wound covering as long as the pore size of the interface layer is small enough to prevent the 0.8mm x 0.8mm grafts from being pulled through the dressing. Tegaderm™ Contact is a recommended interface layer to avoid the disturbance of the micrografts.
If the wound is on the lower extremity, the patient must keep their leg elevated at all times during the 1st week except for 5 min per hour for personal care. During the 2nd week, 10 min per hour is acceptable. On the 3rd week the patient should resume normal ambulation but still with a compressive wrap.
The first dressing change should be performed 5-7 days post grafting procedure.
- Leave interface layer in place and re-apply hydrogel
- Replace new foam dressing and wrap firmly
After 10-14 days the contact layer can be eased off the graft using saline irrigation to prevent any dressing adherence.