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Original Research
Online Published: 11 Mar 2026
 


Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting

Williams Imanuel Mesang, David Perdanakusuma, Indri Lakhsmi Putri.


Abstract
Objective: To compare the effectiveness of biological and conventional dressings on split-thickness skin grafting (STSG) donor wound healing.
Methodology: This quasi-experimental study with post-test control group design was conducted at the Department of Plastic and Reconstructive Surgery, Dr. Soetomo General Hospital, Surabaya, from April to November 2024. A total of 21 patients who underwent intermediate STSG were included. In each patient, four standard donor wounds measuring 50×50 mm were created on the upper thigh, which were randomly allocated to secretome, bacterial nanocellulose (BNC), freeze-dried human amniotic membrane (FDHAM), and paraffin gauze dressing (PGD) groups. Evaluation was performed on days 7, 10, and 14 postoperatively, including area and percentage of epithelialization, epithelialization rate, pain intensity using Visual Analog Scale (VAS), and infection rate based on swab culture. Statistical analysis used Kruskal-Wallis and Mann-Whitney tests.
Results: The secretome group showed significantly higher epithelialization area and rate compared to FDHAM and PGD at all observation times (p<0.05). On day 14, nearly complete epithelialization was achieved in the secretome group (99.9%) and BNC (98.7%). The lowest pain scores were found in the secretome group, followed by BNC, FDHAM, and PGD (p<0.001). Infection rates were significantly lower in the secretome and BNC groups; on day 10, infection occurred in 4.8% of wounds in the secretome group compared to 76.2% in FDHAM and 100% in PGD (p<0.001).
Conclusion: Secretome and bacterial nanocellulose significantly improve STSG donor wound healing by accelerating epithelialization, reducing pain, and decreasing infection rates compared to conventional paraffin dressing, while FDHAM provides moderate effectiveness.

Key words: Wound healing, Secretome, bacterial nanocellulose dressing (BND), Freeze-dried human amniotic membrane (FDHAM), Epithelialization.


 
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How to Cite this Article
Pubmed Style

Mesang WI, Perdanakusuma D, Putri IL. Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. RMJ. 2026; 51(2): 404-409. doi:10.5455/rmj.20250712093743

Web Style

Mesang WI, Perdanakusuma D, Putri IL. Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. https://www.rmj.org.pk/?mno=270529 [Access: May 26, 2026]. doi:10.5455/rmj.20250712093743

AMA (American Medical Association) Style

Mesang WI, Perdanakusuma D, Putri IL. Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. RMJ. 2026; 51(2): 404-409. doi:10.5455/rmj.20250712093743


Vancouver/ICMJE Style

Mesang WI, Perdanakusuma D, Putri IL. Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. RMJ. (2026), [cited May 26, 2026]; 51(2): 404-409. doi:10.5455/rmj.20250712093743


Harvard Style

Mesang, W. I., Perdanakusuma, . D. & Putri, . I. L. (2026) Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. RMJ, 51 (2), 404-409. doi:10.5455/rmj.20250712093743


Turabian Style

Mesang, Williams Imanuel, David Perdanakusuma, and Indri Lakhsmi Putri. 2026. Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. Rawal Medical Journal, 51 (2), 404-409. doi:10.5455/rmj.20250712093743


Chicago Style

Mesang, Williams Imanuel, David Perdanakusuma, and Indri Lakhsmi Putri. "Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting." Rawal Medical Journal 51 (2026), 404-409. doi:10.5455/rmj.20250712093743


MLA (The Modern Language Association) Style

Mesang, Williams Imanuel, David Perdanakusuma, and Indri Lakhsmi Putri. "Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting." Rawal Medical Journal 51.2 (2026), 404-409. Print. doi:10.5455/rmj.20250712093743


APA (American Psychological Association) Style

Mesang, W. I., Perdanakusuma, . D. & Putri, . I. L. (2026) Comparative effectiveness of secretome, bacterial nanocellulose dressing, freeze-dried human amniotic membrane, and paraffin gauze dressing in promoting donor site healing following intermediate split-thickness skin grafting. Rawal Medical Journal, 51 (2), 404-409. doi:10.5455/rmj.20250712093743


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