To observe the effects about the healing of thin medium-thickness skin grafts with three wound dressings.

Thirty-eight autologous skin graft patients in Department of Plastic and Burns, First Affiliated Hospital of Bengbu Medical College from January to December 2020 were selected. Three equal areas identical rectangular thin medium-thickness skins were taken on the same patient′s, which were 1 cm apart and the total area of skin slices taken from each patient was basically the same. The skin of the same patient was divided into three groups: paraffin gauze dressing group, alginate Ag dressing group and silk fibroin wound dressing group. After the skin graft was removed, it was applied separately paraffin gauze dressing, alginate Ag dressing and silk fibroin wound dressing. Wound hemorrhage, pain degree of the patient during the first dressing change[number rating scale (NRS)], wound infection, wound healing time, wound healing effect of the three groups were compared. Data were statistically analyzed with one-way analysis of variance, t test and chi-square test.

(1)Wound hematocele rate: compared with paraffin gauze dressing group(2.63%), alginate Ag dressing group(5.26%), silk fibroin wound dressing group had a higher blood accumulation rate(23.68%), and the differences were statistically significant(χ²=7.370, 5.208; P<0.05), and compared with the blood accumulation rate of paraffin gauze dressing group and alginate Ag dressing group, the difference was not statistically significant (χ²=0.347, P>0.05). (2) Pain degree of the patient during the first dressing change: the NRS score of the silk fibroin wound dressing group was (2.97±1.48)points, which was lower than alginate Ag dressing group[(3.97±1.84) points] and paraffin gauze dressing group[(6.03±1.37)points], the differences were statistically significant(t=4.854, 0.873; P<0.05); the pain score of the alginate Ag dressing group was lower than paraffin gauze dressing group, the difference was statistically significant(t=1.467, P<0.05). (3)Wound infection rate: the infection rate of balginate Ag dressing group was 5.26%, compared with silk fibroin wound dressing group (0) paraffin gauze dressing group(10.53%), the differences were not statistically significant(χ²= 2.054, 0.724; P>0.05); the infection rate of silk fibroin wound dressing group was lower than paraffin gauze dressing group, the difference was statistically significant(χ²=4.222, P<0.05). (4)Wound epithelialization healing time: the would epithelialization healing time of alginate Ag dressing group was (13.69±1.64) d which was shorter than the paraffin gauze dressing group[(11.78±1.43) d] and the silk fibroin wound dressing group[(8.95±1.34) d], and the differences were statistically significant (t=0.953, 1.204; P<0.05). Compared with alginate Ag dressing group, the wound epithelialization healing time of paraffin gauze dressing group was shorter, and the difference was statistically significant (t=2.147, P<0.05). (5)Wound healing effect: there were no differences among three groups in scars and pigmentation.

The silk fibroin wound dressing has defect in wound hemorrhage. However, it has obvious advantages in pain score, wound infection, and wound healing time.