I am interested as there is no current consensus. Also temperature and humidity may affect choice for individual centres.
in the UK the favoured dressing is Kaltostat soaked with 0.5% topical bupivacaine, followed by dry gauze and wool and crepe. The kaltostat (alginate) adheres to the donor site until it has re-epithelialised whereupon it falls off easy. The benefit is that the dressing does not need to be disturbed for 2 weeks.
... of course, the Kaltostat also promotes haemostasis and absorbs exudate, too.
we use Aquacel in 4 layers and tegaderm, it works well with suction of blood and analgesia, we leave it for 4-5 Days and then change the outer aquacel with new ones and the tegaderm until full healing in 2 weeks.
we have undertaken a study for comparing vaseline gauze, Mepitel and Agicoat( iranian product similar to Acticoat) in skin graft donor site. The results are in favor of agicoat.
Semi open technique with vaseline gauze,impregnated with mupirocin ointment.
We favour three different kinds of dressings. In case of large donor sites we use "Allevyn" a PU-foam, which can remain on the wound for a week or longer. For smaller ones we use either "Hyalosafe", a hyaluronic acid foil or "ProHeal", a bovine collagen sheet, which is covered with a hydrokolloid. We see re-epithelsation after 6-8 days.
I do the same as Holmes, in stead of bupivacaine we use only saline to moister the kaltostat. It is cheep, efficient and comfortable. No dressing changes needed. No pain. It falls of when healed. That means, when you can turn the dressing (klatostat, gauze, synthetic wool and crepe) around the leg you can take it of. Usely it takes about two weeks.
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