Comparison of Collagen Dressing Versus Conventional (Paraffin/Cotton Gauze) for Donor Site Dressing in Split Skin Graft Patients: A Prospective Observational Study

Introduction Effective management of donor site wounds following split-thickness skin grafting (STSG) is crucial for optimal recovery, patient comfort, and prevention of complications. Conventional dressings are often associated with delayed healing, increased pain, and higher infection risk. Collagen dressings possess biological properties that may affect the healing process; however, their clinical advantages over conventional dressings remain to be fully established. Methods A prospective observational clinical study was conducted over 18 months (April 2023 - October 2024) at the Department of General Surgery, Sree Balaji Medical College and Hospital. A total of 60 patients undergoing STSG were divided into two groups (n=30 each): one receiving a conventional dressing (paraffin or cotton gauze) and the other a collagen dressing. Wound healing was assessed on postoperative days (PODs) 12, 14, 16, 18, and 22. Pain was evaluated daily for one week using the visual analogue scale (VAS), and other metrics like analgesic usage, infection rates, and patient satisfaction were recorded. Data were analyzed using chi-square and t-tests, with significance set at p<0.01. Results The collagen group showed a significantly shorter mean healing time (13.5 ± 1.9 days) compared to the conventional group (16.8 ± 2.1 days, p<0.001). Pain scores were consistently lower in the collagen group (Day 3 VAS: 3.8 vs. 5.9, p<0.001). Infection occurred in one patient (3.3%) in the collagen group versus five patients (16.7%) in the conventional group (p=0.043). Opioid use was notably less in the collagen group (13.3% vs. 33.3%, p=0.048), and patient satisfaction was significantly higher (very satisfied: 46.7% vs. 13.3%, p=0.008). Conclusion Collagen-based dressings demonstrated superior performance over conventional dressings (paraffin/cotton gauze) in terms of faster healing, better pain control, reduced infection rates, and higher patient satisfaction. Collagen dressings should be considered a preferred option for donor site management following STSG, particularly where enhanced recovery and patient comfort are priorities.