Effectiveness of a Regenerative Epithelial Suspension (RES), on the pigmentation of split-thickness skin graft donor sites in children: the dRESsing pilot randomised controlled trial protocol

• Published in: BMJ open Vol. 14; no. 2; p. e077525
• Main Authors: Bairagi, Anjana, Tyack, Zephanie, Kimble, Roy M, McPhail, Steven M, McBride, Craig Antony, Patel, Bhaveshkumar, Vagenas, Dimitrios, Dettrick, Zoe, Griffin, Bronwyn
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 27.02.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: Clinical trials; Data collection; General anesthesia; Intervention; Paediatric plastic & reconstructive surgery; Pediatrics; Plastic surgery; Scars; Skin & tissue grafts; Surgeons; Surgery; Transplant surgery; Trauma management; WOUND MANAGEMENT
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-077525

BackgroundPaediatric donor site wounds are often complicated by dyspigmentation following a split-thickness skin graft. These easily identifiable scars can potentially never return to normal pigmentation. A Regenerative Epidermal Suspension (RES) has been shown to improve pigmentation in patients with vitiligo, and in adult patients following a burn injury. Very little is known regarding the efficacy of RES for the management of donor site scars in children.Methods and analysisA pilot randomised controlled trial of 40 children allocated to two groups (RES or no RES) standard dressing applied to donor site wounds will be conducted. All children aged 16 years or younger requiring a split thickness skin graft will be screened for eligibility. The primary outcome is donor site scar pigmentation 12 months after skin grafting. Secondary outcomes include re-epithelialisation time, pain, itch, dressing application ease, treatment satisfaction, scar thickness and health-related quality of life. Commencing 7 days after the skin graft, the dressing will be changed every 3–5 days until the donor site is ≥ 95% re-epithelialised. Data will be collected at each dressing change and 3, 6 and 12 months post skin graft.Ethics and disseminationEthics approval was confirmed on 11 February 2019 by the study site Human Research Ethics Committee (HREC) (HREC/18/QCHQ/45807). Study findings will be published in peer-reviewed journals and presented at national and international conferences. This study was prospectively registered on the Australian New Zealand Clinical Trials Registry (available at https://anzctr.org.au/ACTRN12620000227998.aspx).Trial registration numberAustralian New Zealand Clinical Trials Registry [Available at https://anzctr.org.au/ACTRN12620000227998.aspx]