MATERIALS AND METHODS
Between January 2018 and July 2018 10 patients presenting unhealed skin graft donor site with hypergranulation were enrolled at the Plastic and Reconstructive surgery department of Legnano Hospital (Milan).
The Study was conducted according to the declaration of Helsinki for biomedical research on human subjects.
The age of patients ranged from 35 to 70 years and all the donor sites were on the upper third of the legs.
Due to well-known side effects of steroid treatment all patients presenting diabetes, active infections, immunodepression, and hypersensitivity to steroids were excluded.
The decision of applying topical steroids was made by the plastic and reconstructive consultant.
After cleansing with sterile saline water a topical 0,25 mg Betamethasone diproprionate + 5 mg Neomycin Sulfate ointment was applied to the wounds followed by application of a non adherent gauze and an occlusive bandage.
The dressing was removed after 5 days and after gently cleansing with sterile water the result was assessed.
The outcome after every dressing was graded as:
-Poor response : no reduction in ulcer size. Still presence of hypergranulation and exudate.
-Good response : absence of hypergranulation and low exudate. Still lack of epithelization. (Fig. 1-a,1-b,1-c)
-Optimal response - totally re-epithelized wound. No evidence of hypergranulation.
If needed, a second treatment was eventually performed with the same modalities described above.
In addition the patients were asked to evaluate the pain during treatment with a V.A.S. pain scale.
During each dressing photos of the wounds were taken.