Page 5 - OxyBand Research Background

Journal of Burn Care & Research
Volume 35, Number 3 Lairet et al 217

appearance, four patients’ OxyBand wounds were The type of dressing used did not have an impact
judged to have better cosmetic outcome, and five on the final cosmetic outcome of the wound. There
patients’ Xeroform wounds were deemed to have was no pattern formation in the final OxyBand
better cosmetic appearance. wounds at 30 to 45 days, and cosmetic appearance
Nursing time was not measured in this study. Each was judged to be similar to the control Xeroform
patient visit required 30 to 45 minutes of hands-on wounds by independent surgeons familiar with burn
time by the research nurse, or up to 60 minutes if wounds.
photographs were taken. The time required to per- A border of approximately 2 cm on all sides of
form an OxyBand dressing change was on the order the wound is required for the OxyBand dressing to
of 2 minutes. adhere, which must be taken into consideration. At
the time of this clinical study, only one size of the
DISCUSSION dressing was available. This, of course, is a limita-
tion in comparison with Xeroform, which can be
The harvesting of donor sites during split-thickness trimmed to fit or pieced together to fit virtually any
skin-grafting procedures creates a new wound. Care size wound. Although a variety of sizes and configu-
of such wounds involves techniques to promote rations of the OxyBand dressing could be manufac-
rapid reepithelialization. The longer the wound tured, it still likely will require some uninjured skin
remains open, the higher the risk of infection. Dress- around the margins to allow the dressing to adhere.
ings that optimize the donor-site healing allow for Xeroform dressing has been widely available for
reharvesting of donor sites more rapidly, which can many years and is inexpensive. The commercial cost
be life-saving for patients with large burn surface area of OxyBand dressings is not yet known, but will
involvement. Dressings such as Xeroform have been almost certainly cost more than Xeroform gauze.
used for many years as donor-site dressings because The decreased levels of pain reported by patients,
of their availability, low cost, and relative ease of and possibly the decreased requirements for pain
application. This study prospectively compared a medication as a result, may help offset the price of
new product, OxyBand, with our control donor-site the OxyBand dressing. It is also difficult to place a
dressing, Xeroform. Healing time, as well as per- price on the value of time to healing. For a patient
ceived pain and cosmetic outcome, were assessed. with a large percent body surface area full-thickness
We found a statistically significant decrease in the burn, speeding healing by a few days would allow
healing time of donor-site wounds dressed with the more rapid coverage of the excised wounds with
OxyBand dressing compared with the Xeroform- autologous tissue. This may prevent an infection or
dressed wounds. Not one of our subjects had a reduce the amount of temporary closures (allograft,
donor wound dressed with Xeroform heal faster than Integra, or other products) before final closure is
the study wound, although some subjects’ wounds achieved.
were found to be healed on the same day. A limitation of the study involved being able to
Our results also demonstrated that the OxyBand determine the day of healing of each wound. This
dressing was associated with less pain at each post- issue was multifactorial. In a few instances, patients
operative data-collection point. Subjects’ comments were late for follow-up visits, so the true day of heal-
about the dressings were recorded at their final ing may have been the day prior. Also, the OxyBand
30- to 45-day visit, and every patient who made dressing was not removed every day to inspect the
a comment had a positive remark about the com- wound. To maximize the benefit the wound would
fort of OxyBand dressings. No such remarks were receive from being in an oxygen-saturated environ-
made about the comparison dressing. The OxyBand ment, the decision was made to initially only remove
dressing keeps the wound occluded and moist dur- the dressing on postoperative days 4 and 8. The fre-
ing the healing process. In contrast, Xeroform is left quency of dressing changes was then increased to
exposed to the air in order to dry. It eventually hard- every 2 days in an attempt to more closely capture
ens before it separates from the wound as it is reepi- the day of healing, as our experience has been that
thelialized. The nonadherent characteristic of the most donor wounds are healed approximately 10 to
OxyBand dressing (with regard to the wound) may 14 days after skin harvest. Perhaps if the dressing was
explain the decreased pain reported at the wound changed daily, we may have more accurately identi-
site by subjects. Whether topical oxygen also modu- fied the day of healing. This idea was rejected, how-
lates the pain response is unknown. Further studies ever, as patient compliance with the follow-up visit
should be done to look more closely at the relation- schedule may have been reduced. Another limitation
ship between oxygen-diffusion dressings and pain. is the unblinded nature of this study.