Fig. I Donor site that has been just sampled. Fig. 2 During application of the hydrocolloid dressing. Fig. 3 Donor site healed at day 7.

This synthetic dressing was tested on small and medium donor sites of 30 patients (23 men and 7 women). The patients' age ranged from 10 to 88 years (mean age 54). The causes of the loss of skin are shown in Table 3. The thickness of the split skin graft was from 0.3 to 0.5 ram. Table 4 shows the location of the donor sites. Once the skin had been sampled (Fig. 1), bleeding was prevented with compression with saline or H202 gauze for a few minutes. The gauze was then carefully removed and the site allowed to dry.
The plaque was applied to the area (Fig. 2), taking care to extend it about 2 cm over the edges of the site to be treated (Fig. 3). In 10 cases the smallest Comfeel (R) plaque was used, in 9 cases the 15 em size, and in 11 cases the largest size.
Additional compression was achieved with a cr~pe bandage in 23 cases. In 4 other cases, elastic adhesive tapes maintained mild compression.
The first change of the dressing was performed depending on the conditions of the sampled zone (Table 5) (Fig. 4, 6).
Application of a fresh plaque was found to be a rapid process. Twelve cases needed a second fresh plaque and 2 cases a third. The second dressing was applied between day 6 and day 12. The third change was not necessary before day 8.

Results
The removal of the first plaque and the application of a new one was a rapid process. Despite their pliability, the wrinkles and air-bubbles during this operation caused some difficulties. The transparency of the dressing was considered a good property for checking the healing of donor sites. Moderate pain occurred with the changing of the dressing during early post-operative care in 5 cases. The dressing was a good option for the treatment of donor sites in children because the procedure was painless. Three cases of local contamination occurred, and the normal protocol was suspended. We were not able to demonstrate infection. One case of allergic reaction was observed (Fig. 5). The average healing time was 8.15 days, although total epithelialization occurred by day 6 in 4 cases. The appearance of the site after one month's healing was good, with no hypertrophic or other pathological scars. There were no differences compared to the fine pink skin of other forms of treatment of donor site, except for the time that the new cells needed to cover all the surface. The cost of treatment was reduced compared to that of traditional dressings.

Fig, 4 In some cases, it was necessary to aspirate some exudate without any change of the plaque. Fig. 5 One case with folliculitis around the sampled donor site. Fig. 6 In one case, it was necessary to keep the plaque for 2 1 days, because the donor site for a cross leg flap was under a splint.

Discussion
Split-thickness skin grafting (STSC) is a widely used technique for the coverage of skin defects. It is used by general and plastic surgeons and other surgical specialists (fo r example, orthopaedics and otolaryngologists). The STSG donor site often has more problems than the original defect which has been grafted.
An ideal dressing would promote rapid infection-free healing, cause little pain to the patient. require minimal nursing care and be inexpensive to use.
Although the ideal donor site dressing has yet to be discovered, some individualized recommendations can be made for specific situations based on current studies.
Small donor sites should be covered with an occlusive or semiocclusive dressing as the amount of fluid leakage is usually reasonable, and it is cheaper to use. These dressings are the most comfortable for the patient and allow reepithelialization in approximately 10 days.
Large donor sites can be treated with semi-open dressings (fine mesh gauze). Dressing care and cost is minimal, and healing occurs predictably in 10 to 14 days.

Conclusions
We demonstrate that Comfeel (R), a hydrocolloid dressing, is a good option, because the time necessary for the healing of donor sites is shorter and the cost cheaper than for traditional dressings.
The greatest benefit of occlusive dressings has been to bring about the realization that the wound and its microenvironment can be greatly modified by whatever covers them. The dressing is therefore a pharmacological agent, and appropriate modifications may improve its effect. Occlusive dressing therapy has a bright future, with the purification and cloning of numerous growth factors. It is likely that we will see "growth dressings" that combine occlusion with the pulsed delivery of specific growth factors designed to help a specific clinical problem.
But we must not forget that, in chronic wounds, technical modifications in occlusive dressings can help to treat the underlying cause. In decubitus ulcers for example, we could use dressings that redistribute pressure over a larger area.
These are some of the exciting developments that we can expect in the near future with regard to occlusive therapy.

RESUME 11 n'existe pas aucun accord général entre les chir-urgiens pour cc qui regarde le pansement de premier choix dans les sites donneurs de peau A épaisseur variable. Cet article présente les exp&riences du traitement avec un pansement hydrocolloide (Comfeel (R) ) de 30 sites donneurs de peau d'extension petite et moyerme. Les résultants montrent des avantages importants par rapport aux pansements traditionnels.

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