Clinical evaluation of coverage of open wounds: Polyglycolic acid sheet with fibrin glue spray vs split thickness skin

Ann Maxillofac Surg. 2016 Jul-Dec;6(2):228-234. doi: 10.4103/2231-0746.200346.

Abstract

Purpose: This study aimed to evaluate the coverage of oral wounds using either a polyglycolic acid (PGA) sheet or split-thickness skin grafting (STSG).

Materials and methods: A total of 119 cases of wound coverage using a PGA sheet and fibrin glue spray as well as 132 cases of wound coverage cases using STSG were reviewed retrospectively. The site of the excision area, perioperative conditions, and postoperative functional problems were evaluated.

Results: The PGA group had significantly shorter operation time, earlier start of oral intake, and shorter hospitalization than the STSG group. If the PGA sheet over the wound with exposed bone could be protected by a surgical sprint, oral food intake could be started on the day after surgery at the earliest. When the size of the wound in the buccal excisional area was classified into two groups (<6 or ≥6 cm2), mouth opening in the STSG group was significantly larger at 3 months postoperatively. When the size of the wound in the tongue and floor of mouth was classified into two groups (<12 or ≥12 cm2), the STSG group had a significantly higher score in postoperative speech intelligibility.

Conclusion: Selection of a PGA sheet or STSG based on the consideration of defect size, tumor location, patients' local and general condition and tolerance for surgery could reduce the patients' postsurgical dysfunctional problems.

Keywords: The second operation for tumor recurrence; exposed bony wound; higher aged patients; intraoral surgical defect; oral mucosa; polyglycolic acid sheet; split-thickness skin grafting.