Skin graft healing & scar prevention

“In a moist environment exudate provides the cells involved in wound repair with nutrients, controls infection, and provides the best environment for healing.”

This statement is very true, but the orthodox method of maintaining a moist environment for optimal wound healing is mechanistic and basically flawed. We know that exudate is a crucial product of the natural healing process and contains the necessary growth factors that bring about that healing. By allowing exudate to form above the wound surface, absorb it with a dressing then remove it when the dressing is changed is to waste this all-important natural healing resource. The aim therefore should be to retain exudate under the wound surface to enable it to perform optimally its natural function. Wheatgrass helps facilitate and achieve this function by sealing the wound surface and preventing exudate loss.

In this case, a 50 year old businessman suffered a large, deep injury to his left lower leg when attacked by a pit bull terrier. A split skin-graft was applied to the wound on the same day and orthodox medical management of providing a so-called “wet” environment commenced.

Antibiotic dressings that kill bacteria (but suppress the immune response and rate of healing of body surface tissues) were also applied.

Keeping the wound moist is an age-old concept mainly based on clinical experience, conventional wisdom and research that shows cells grow faster in wet rather than dry environments.

My approach is precisely the opposite. I use a wound-healing wheatgrass extract that keeps the surface dry by default i.e. by sealing the wound with a new layer of epithelial (skin) cells. This allows new cell growth to occur underneath the surface layer. Wheatgrass is known to stimulate the production of growth factors. These factors are responsible for new cell production throughout the body, including tissue repair in the process of wound healing.

This almost invariably results in:

  • A faster healing wound
  • Virtually pain-free dressing changes. Because the wound surface re-epithelialises i.e. a thin layer of cells spreads over the wound within 24-48 hours, exudate, which can be quite sticky and tends to adhere to overlying dressings, is greatly reduced or eliminated. This provides a “non-stick” surface.
  • Prevention of bacterial infection
  • Minimal scarring
  • Elimination of blood, ooze, clot formation, swelling and inflammation
  • Significant cost reduction e.g. dressings, nursing care, antibiotics, medical management

Instead of interfering with the natural healing process, wheatgrass facilitates it.

In this patient, the skin graft failed to “take”‚ requiring time-consuming and costly regular antibiotic and other dressing changes every few days over the following six weeks. Considerable discomfort occurred each time dressings were removed due to exudate adhering to the dressing.

Fig. 1. DAY 43 – Orthodox management. The antibiotic dressing has been removed leaving a brown discolouration on the skin and a wet surface which is due to exudate.

Note the rough surface of the grafted skin (whitish color), poor, irregularly contoured attachment to the surrounding normal skin and raised areas of granulation tissue. (These are the yellow and red irregularly shaped areas that indicate the body’s attempt to heal the overlying surface. It is not due to infection.)

The wound was cleaned, wheatgrass extract (4% solution) applied then redressed with a light, non-stick dressing. (Melolin). The patient was asked to change the dressing daily.

 

Fig. 2. DAY 45. Just two days after the first application of wheatgrass extract there is dramatic improvement in the surface of the skin graft. Even to the unpracticed eye the wound is looking much healthier. Note the dry wound surface with a thin layer of re-epithelialisation (re-growth of new skin cells) visible over the yellow granulation areas. This seals the wound surface naturally rendering it impermeable to bacteria and preventing infection.

There is substantial filling in of the previously depressed areas‚ covered by the graft seen in Figure 1. The grafted skin is now looking strong and healthy and has blended seamlessly with the surrounding normal skin. The irregular border has smoothed out as has the surface of the granulation tissue. The wound is quite clean,  free of infection and dry.

 

Fig. 3. DAY 50. One week after the first application of wheatgrass extract, skin coverage, which appears strong and increasingly integrated with normal surrounding skin, has progressed significantly as granulation areas continue to contract.

Fig. 4. DAY 55. Twelve days after the first wheatgrass extract application, the wound is almost completely covered with strong looking skin. Apart from two very small areas of granulation, only scab formation remains. This will now heal naturally with dressings used for protection only.

Fig. 5. DAY 63. 20 days after the first wheatgrass extract application.  Wound healed. No dressing required.

IN SUMMARY: This series of photographs clearly shows rapid healing of a skin-grafted wound that for six weeks remained indolent and only partially healed with orthodox management i.e. keeping the wound moist.

Wheatgrass extract was applied after 6 weeks of “orthodox” treatment effectively sealing the wound and rendering it dry. Just two days after the first application, significant improvement was observed to the wound surface which continued to improve rapidly. The patient managed his own dressing changes with ease, and, other than returning for photographs, required no further medical or nursing attention.

In this example, as in numerous others I have managed since 1995, I have no doubt that wheatgrass could revolutionise the effectiveness and economics of skin graft, open wound and burns management.

View another example.

Testimonial:
An 86 year old man had an SCC removed from the apex of his head with a split skin graft applied. He was given 2 weeks of radiotherapy to the area before the skin graft had healed. He was sent home with a warning that the whole area would breakdown and that his whole scalp would probably slough off as well.
As soon as I saw him I sprayed his whole head with the wheatgrass extract and put a dry, non-stick dressing over the graft site. The erythema (redness) on his scalp had markedly reduced by the next day and the graft site was looking so much better.
We did the WG spray every 2nd day over the following 2 weeks. The scalp didn’t even peel. The skin graft healed beautifully. This fellow has assured me that he will take the spray to show his medicos what healed the graft site and the radiation burns. I can’t wait to hear what their reaction will be.
E. T. Domiciliary Nurse. Australia. 19 July, 2017