References
Extra-wound fixation: a modified tie-over dressing technique for skin graft
Abstract
Objective:
Tie-over dressing is the most frequently used technique of skin grafting. However, many deficiencies affecting the outcome have been reported. We hereby introduce a modified method, termed the ‘extra-wound fixation technique’, for skin dressing, and evaluate the complications and clinical outcomes.
Method:
In this retrospective cross-sectional study we analysed the medical records of patients treated between January 2012 and December 2017. All patients received full thickness skin grafts. Patients were divided equally into to groups: patients were treated using the extra-wound fixation technique, and the remaining, randomly selected patients treated using the traditional tie-over method. The extra-wound fixation technique uses the traditional tie-over dressing method followed by additional stitches made in healthy skin locating 0.5-1.0 cm laterally to the wound edge. The follow-up outcomes between the two groups were compared using the Chi-square test.
Results:
A total of 38 patients took part (19 patients in each group). The follow-up duration was 1–6 months. No raised edges were observed in any of the patients. Prolonged follow-up demonstrated that the grafted skin texture became soft with a thin layer of adipose tissue, and elasticity was gradually improved along with the regeneration of dermoelastic fibre. The colour was similar to the normal skin with a smooth surface. Compared with the traditional method, the extra-wound fixation technique significantly improved the survival of the grafted skin (p=0.008), reduced the risk of laceration of the skin (p=0.001), and eliminated crater rim-like appearances (p=0.020).
Conclusion:
The extra-wound fixation technique could be used for different skin grafts and improve clinical outcomes compared with the traditional tie-over dressing method.
Traditional tie-over dressing is the most frequently used method for free-skin grafting.1,2 It is compatible in many clinical situations. Nonetheless, the suture threads that are located at the edges of a wound can result in raised edges of the grafted skin, like a crater rim.3 More seriously, complications can arise, such as necrosis, effusion or haemorrhage of the local skin.4 These shortcomings may affect the survival and appearance of the grafted skin. This traditional method is not appropriate for some complicated circumstances with high requirements in plastic and hand surgery, for example where there is a need for flexibility. This report introduces a modified tie-over dressing technique—extra-wound fixation—which was successfully performed in patients with skin defects.
In this observational cross-sectional study, the medical records of individuals who had been patients between January 2012 and December 2017 were retrospectively analysed. Patients were divided equally into two groups:
Register now to continue reading
Thank you for visiting Journal of Wound Care's Silk Road Supplement and reading some of our peer-reviewed resources for healthcare professionals across Asia. To read more, please register today.