If the donor site is treated with dry exposure, promote air circulation to the wound by positioning the client to avoid pressure on the site and using an overbed cradle to tent the sheets. In the rare instance when heart lamps are prescribed, place the 60- to 100-watt bulb at least 2 feet from the wound to prevent thermal injury to the skin. After the dressing has dried and form “scab” keep the wound dry and undisturbed until healing is evident {at 10 to 14 days}. As the donor site heals. The gauze and dried blood lift away from the new epithelium beneath. Trimming the separating gauze close to the skin surface reduces the chance of the client’s catching the loose end of the dressing on an object and removing the still adherent gauze before healing is complete. Today most surgeons prefer to dress donor sites withmoisture-retentive dressings, such as synthetic transparent films, instead of the traditional dry exposure method of treatment
Because exposed donor sites are initially more painful than graft sites, give pain medication as prescribed and provide other comfort measures as needed. Reposition the client during the immediate period after surgery to promote comfort only if movement of the graft site can be avoided. Offer back rubs to help relieve muscle relieve muscle spasms that occur with reduced mobility. Pay attention to relieving pressure over unaffected bony prominences that may lead to additional ulcers.
Graft and donor sites on posterior body surfaces present a particular problem. For the graft or flap to become fully vascularized or for the donor sites to dry, the client must be immobilized in a side-lying or prone position for 7 to 10 days.
An alternative to this positioning is the use of special low-pressure or air-fluidized beds, which not only reduce ischemia of the graft or flap while the client is supine but also help prevent breakdown of intact skin. A major limitation to the use