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An easy and safe method of split-thickness skin graft fixation
burns 33 (2007) 1074–1075
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/burns
Letter to the Editor
An easy and safe method of split-thickness skin graft fixation Sir, The revascularization of a split-thickness skin graft depends on immobilization of the graft on the wound bed. In cases when circular dressings are needed, the graft could be mobilized during the surgical procedure, leading to a partial lost of the graft and subsequent ulcerated areas and infection. There are several methods described to fix skin grafts on the wound bed. The use of stitches is a common method of fixation but it is quite time consuming [1], difficult to do in the split-thickness graft, very expensive and the stitches must be removed. The use of staplers is also described [2] but the inconvenience of not being available and expensive in some centers. The staplers must be removed with the skin stapler remover.
Fig. 2 – The grafts fixed with the surgical tape.
Fig. 1 – The area to be grafted.
However, in the absence of the skin stapler remover some surgeons use an artery forceps to remove it, but when the stapler is removed they can fly in different direction and can cause injury in the surgeon or staff [2]. The use of surgical drape placed over the graft has been recognised [3] but must be removed at the second or third day [3] when the grafts are not well vascularized and this can lead to failure of the graft. Instead of these methods we present an easy, fast, nonexpensive and secure way to avoid the mobilization of the grafts during tying by fixing the grafts and the healthy skin to one another with surgical micro-porous tape (Micropore, SteriStrips-3M Health Care) (Figs. 1 and 2).
burns 33 (2007) 1074–1075
This well known method has the advantage of being easy to apply, non-expensive, available in many countries and easily removed without any instruments and must be remembered by the surgeons when fixing their splitthickness skin grafts. The surgical tape can remain fixing the grafts until its total revascularization leading to good results.
1075
¨ zdengill E, Emsen I. Split-thickness skin [3] Yenidu¨nya MO, O graft fixation with surgical drape. Plast Reconstr Surg 2000;106(6):1429–30.
Roberto Rudge Ramos* Department of Surgery, Federal University of Sao Paulo, Alameda Lorena 427, Sala 100/101, Sa˜o Paulo 01424000, Brazil
references *Tel.: +55 11 30628664; fax: +55 11 38849667 E-mail address: [email protected] [1] Mah E, Morrison WA. A stitch in time (Save Mines). Plast Reconstr Surg 2006;117(7):2535–6. [2] Alexander G, Al-Rasheed AA. Skin stapler removal by artery fo´rceps: a hazardous practice? Burns 2005;31(1): 116.
0305-4179/$32.00 # 2007 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2007.03.027
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/burns
Letter to the Editor
An easy and safe method of split-thickness skin graft fixation Sir, The revascularization of a split-thickness skin graft depends on immobilization of the graft on the wound bed. In cases when circular dressings are needed, the graft could be mobilized during the surgical procedure, leading to a partial lost of the graft and subsequent ulcerated areas and infection. There are several methods described to fix skin grafts on the wound bed. The use of stitches is a common method of fixation but it is quite time consuming [1], difficult to do in the split-thickness graft, very expensive and the stitches must be removed. The use of staplers is also described [2] but the inconvenience of not being available and expensive in some centers. The staplers must be removed with the skin stapler remover.
Fig. 2 – The grafts fixed with the surgical tape.
Fig. 1 – The area to be grafted.
However, in the absence of the skin stapler remover some surgeons use an artery forceps to remove it, but when the stapler is removed they can fly in different direction and can cause injury in the surgeon or staff [2]. The use of surgical drape placed over the graft has been recognised [3] but must be removed at the second or third day [3] when the grafts are not well vascularized and this can lead to failure of the graft. Instead of these methods we present an easy, fast, nonexpensive and secure way to avoid the mobilization of the grafts during tying by fixing the grafts and the healthy skin to one another with surgical micro-porous tape (Micropore, SteriStrips-3M Health Care) (Figs. 1 and 2).
burns 33 (2007) 1074–1075
This well known method has the advantage of being easy to apply, non-expensive, available in many countries and easily removed without any instruments and must be remembered by the surgeons when fixing their splitthickness skin grafts. The surgical tape can remain fixing the grafts until its total revascularization leading to good results.
1075
¨ zdengill E, Emsen I. Split-thickness skin [3] Yenidu¨nya MO, O graft fixation with surgical drape. Plast Reconstr Surg 2000;106(6):1429–30.
Roberto Rudge Ramos* Department of Surgery, Federal University of Sao Paulo, Alameda Lorena 427, Sala 100/101, Sa˜o Paulo 01424000, Brazil
references *Tel.: +55 11 30628664; fax: +55 11 38849667 E-mail address: [email protected] [1] Mah E, Morrison WA. A stitch in time (Save Mines). Plast Reconstr Surg 2006;117(7):2535–6. [2] Alexander G, Al-Rasheed AA. Skin stapler removal by artery fo´rceps: a hazardous practice? Burns 2005;31(1): 116.
0305-4179/$32.00 # 2007 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2007.03.027