Dressing Influence on Re-epithelialization Rate Following Split-thickness Skin Graft Harvest: Network Meta-analysis of Randomized Controlled Trials.

Background: More than 160,000 skin grafts are performed annually in approximately 1 out of every 3 burn hospitalizations individually because they are primarily simple and quick. This network meta-analysis aimed to compare different conventional dressing options based on re-epithelialization time and side effects for split-thickness skin graft donor sites. Methods: As per preferred reporting items for systematic reviews and meta-analysis guidelines, a thorough systematic review and network meta-analysis were conducted. A comprehensive search was performed using MEDLINE, Cochrane, and Embase databases, and all publications published before August 2023 were included without time restrictions. Results: This study performed a network meta-analysis of 25 unique randomized controlled trials published between 1983 and 2022. We found that alginate is the most often used, followed by paraffin gauze. Nonetheless, povidone-iodine-impregnated foam (Betafoam) was the most effective (90.4%), followed by hydrocolloid (87.9%). Petrolatum (73.5%) is associated with faster re-epithelialization than alginate (40.6%) and paraffin (18.1%). Cotton gauze ranked as the worst modality for skin graft donor-site dressing (3.9%). Conclusions: This study serves as a guide for the selection of proper dressing for patients undergoing partial-thickness skin graft harvest. Even though povidone-iodine-impregnated foam was the most effective, we recommend further research comparing other factors for selecting dressings, such as wound and patient characteristics, availability, and costs of dressings.