Pirfenidone increases the epithelialization rate of skin graft donor sites

Abstract Background Improving epithelialization of donor sites of split-thickness skin grafts (STSG) is extremely important in burned patients. We aimed to assess the efficacy of pirfenidone, a drug with anti-inflammatory, antifibrotic, and antioxidant effects, to accelerate wound healing. We hypothesized that pirfenidone accelerates the epithelialization rates in donor sites. Methods We included 28 patients requiring STSGs with donor sites of at least 7.5 × 10 cm. After harvesting, the donor sites were randomly treated with either non-adherent gauze or topical pirfenidone and covered with non-adherent gauze. To assess epithelialization, biopsies were taken at day 7 and 10 on the pirfenidone group, and at day 10 on the control group. Percentage of epithelialization was assessed on the same days through clinical photographs. The pathologists and the clinical observer were blinded to the group and timepoint of the samples. Results 24 patients were included in the study, with a median age of 21(5–73) for control group and 28(9–61) for pirfenidone. The thickness of epithelium was 75.10 ± 60 μm at day 10 for the control group; and 98.21 ± 6 μm at day 7, and 108 ± 22 μm at day 10 for the pirfenidone group (p =  Conclusions Pirfenidone is efficient in reducing the healing times when applied in STSG donor sites, at both days 7 and 10.