Sterile adhesive tape: A useful adjunct when applying full-thickness skin grafts Jungyoon Ohn, MD,a Ji Soo Lim, MD,a and Je-Ho Mun, MD, PhDa,b Seoul, Korea Key words: adhesive tape; full-thickness skin graft; steristrip; surgical pearl; surgical tip.
SURGICAL CHALLENGE Full-thickness skin graft (FTSG) surgery is a valuable technique for repairing surgical defects. FTSG is particularly useful in the reconstruction of defects in certain parts such as the ear, nose, and periocular areas, which have low tissue laxity.1 However, unlike local flap surgery, placing the donor tissue accurately on the recipient skin is difficult, especially when performing the surgery without ample assistants. The donor tissue, not attached to the adjacent soft tissue, is floating like a small boat on the sea. Therefore, surgeons cannot easily fix the flap on the defect site during the suture (Fig 1).
Fig 1. Graft tissue harvested from the donor site is not attached to the adjacent skin, making it difficult for the surgeon to operate.
From the Department of Dermatology, Seoul National University College of Medicinea and Institute of Human-Environment Interface Biology, Seoul National University.b Funding sources: None. Conflicts of interest: None declared. Correspondence to: Je-Ho Mun, MD, PhD, Department of Dermatology, Seoul National University Hospital, 101 Daehangno, Chongno-gu, 110-744, Seoul, Korea. E-mail:
[email protected].
J Am Acad Dermatol 2016;74:e133-4. 0190-9622/$36.00 Ó 2016 by the American Academy of Dermatology, Inc. http://dx.doi.org/10.1016/j.jaad.2015.12.056
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e134 Ohn, Lim, and Mun
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SOLUTION We present a simple and useful tip for the intraoperative use of the sterile adhesive tape in FTSG surgery. Mohs micrographic surgery in a 65-year-old woman with basal cell carcinoma left a 16- x 12-mm sized defect on the medial side of the right nasojugal fold. The defect was reconstructed with a FTSG harvested from the postauricular skin. In this patient, we used sterile adhesive tapes (Steristrip; 3M, St Paul, MN) to fix the flap in place temporarily and sutured the graft tissue at both ends. This helped suture its free edges faster and more accurately (Fig 2). After suturing both ends, we removed the tapes and successfully completed the engraftment. Because of a limited budget, ample assistants are often not available during surgery. In this regard, sterile adhesive tapes are easily accessible and cost-effective assistants during FTSG surgery.
Fig 2. Sterile adhesive tapes applied on the donor tissue make it stationary on the surgical defect, helping the surgeon stitch the small flap onto the defect more precisely. REFERENCE 1. Zhang AY, Meine JG. Flaps and grafts reconstruction. Dermatol Clin. 2011;29:217-230, viii.