Nanofiber Matrix Dressing for Split-Thickness Skin Graft Donor Sites: A Randomized Comparative Clinical Study.

BACKGROUND

Donor-site morbidity after split-thickness skin graft (STSG) harvest remains a significant clinical concern, with pain representing one of the most burdensome early postoperative symptoms. Electrospun nanofiber matrices have emerged as a promising wound management strategy, yet clinical evidence supporting their use in STSG donor sites remains limited. We evaluated the clinical performance of a nanofiber matrix for donor-site management after STSG harvest.

METHODS

This single-center randomized comparative study enrolled 40 adult patients undergoing STSG harvest into either the nanofiber matrix group (n=20) or the conventional dressing group with chlorhexidine paraffin gauze and povidone-iodine gauze (n=20). Pain intensity was measured on a 0-10 scale on postoperative days 1, 2, 5, and 14. Secondary outcomes included donor-site healing time, pruritus during healing, late scar hyperpigmentation, scar elevation, late pruritus, and local or systemic signs of infection.

RESULTS

Compared with conventional management, the nanofiber matrix significantly reduced donor-site pain on postoperative day 1 (p<0.001), day 2 (p<0.001), and day 5 (p=0.015), but not on day 14 (p=0.36). The nanofiber group also healed faster than the control group (15.05±2.34 vs 18.15±4.38 days; p=0.045). Pruritus during healing did not differ significantly between groups (p=0.97). At late follow-up, we found no significant between-group differences in hyperpigmentation (p=0.11), scar elevation (p=0.051), or late pruritus (p=1.0). Mild exudate occurred in 3 patients in the nanofiber group, without a significant between-group difference (p=0.12), and we identified no other infection-related complications.

CONCLUSION

Nanofiber matrix dressing reduced early postoperative pain and shortened healing time at STSG donor sites compared with conventional dressing, while late scar outcomes and short-term safety remained comparable between groups. These findings support the potential of nanofiber-based donor-site management as a clinically relevant translational application of electrospinning technology.