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Use of surgical adhesive tape (steri-strips) to secure skin graft on digits
Use of Surgical to Secure
Adhesive
Tape
Skin Graft
(Steri-Strips)
on Digits
GERSHON EFRON, M.B., M.MED. (Surg.), F.R.C.S. (Eng.) AND RALPH GER, M.B., F.R.C.S. (Eng.), F.R.C.S. (Edin.), Bronx, New York
From the Deparhent of Surgery, Albert Einstein College of Medicine, Bronx, New York. Reprint requests should be addressed to Dr. Gershon Efron, Department oJ Surgery, Lincoln Hospital, 333 Southern Blvd., Bronx, New York 10454.
to the digits I NJURIES especially in industrial
are very common areas. It is agreed that skin loss should be replaced by a partial or full thickness skin graft, the thickness varying with the preference of the surgeon [l 1. The usual method of fixation of these grafts has been to suture them to the edges of the defect. This has many disadvantages [Z], in particular the need to anesthetize the digit and the insertion and removal sf fine sutures which achieve special importance in children. The use of surgical tape to secure skin grafts has been well documented [Z-P]. It has been used on flat surfaces, but apparently not for grafts on the digits. In this situation it is extremely useful, as it can be applied even more securely than on flat surfaces where an occasional suture is often necessary to aid immobilization of the graft [Z]. The wound is cleaned and the graft is obtained in the usual manner, cut to size, and applied to the defect. The rest of the digit is dried and two or more Steri-Strips@* are applied, encircling the finger and crossing the graft. The advantage is that the tape encircles the whole digit leaving a generous portion still free which may then be applied to the preceding complete circle to create excellent fixation. (Fig. 1.) A tube gauze dressing completes the closure. The Steri-Strips may be applied along the length of the digit or in a crisscross
FIG. 1. Partial thickness skin graft on wound secured by Steri-Strips on fifth postoperative day.
fashion, whichever seems to give the best fixation of the graft. This method of skin graft fixation has been used in twenty-seven patients over the past year and we have found it to be satisfactory and reliable. All the patients were treated in the emergency room and seven of them were children. SUMMARY A simple and efficient method of skin graft fixation using Steri-Strips and which is applicable to patients seen in the Emergency Room especially children is described. 1.
REFERENCES
J. R. Partial-thickness skin grafting of finger-tip injuries. Lancet, 1: 705, 1967. 2. FISCHL, R. A. Skin grafting: a new technique. Brit. J. Plast. Surg., 18: 435, 1966. 3. DUNPHY, J. E. and JACKSON, D. S. Practical applications of experimental studies in the care of the primary closed wound. Am. J. Surg., 104: 273, 1962. 4. GOLDEN, T. G., LEVY, A. H., and O’CONNOR, W. T. Primary healing of skin wounds and incisions with a threadless suture. Am. J. Surg., 104: 603, 1962.
* Manufactured by the Minnesota Mining and Manufacturing Company, St. Paul, Minnesota. 474
SALAMON,
l’he Am&can
Journal
of Surgery
Adhesive
Tape
Skin Graft
(Steri-Strips)
on Digits
GERSHON EFRON, M.B., M.MED. (Surg.), F.R.C.S. (Eng.) AND RALPH GER, M.B., F.R.C.S. (Eng.), F.R.C.S. (Edin.), Bronx, New York
From the Deparhent of Surgery, Albert Einstein College of Medicine, Bronx, New York. Reprint requests should be addressed to Dr. Gershon Efron, Department oJ Surgery, Lincoln Hospital, 333 Southern Blvd., Bronx, New York 10454.
to the digits I NJURIES especially in industrial
are very common areas. It is agreed that skin loss should be replaced by a partial or full thickness skin graft, the thickness varying with the preference of the surgeon [l 1. The usual method of fixation of these grafts has been to suture them to the edges of the defect. This has many disadvantages [Z], in particular the need to anesthetize the digit and the insertion and removal sf fine sutures which achieve special importance in children. The use of surgical tape to secure skin grafts has been well documented [Z-P]. It has been used on flat surfaces, but apparently not for grafts on the digits. In this situation it is extremely useful, as it can be applied even more securely than on flat surfaces where an occasional suture is often necessary to aid immobilization of the graft [Z]. The wound is cleaned and the graft is obtained in the usual manner, cut to size, and applied to the defect. The rest of the digit is dried and two or more Steri-Strips@* are applied, encircling the finger and crossing the graft. The advantage is that the tape encircles the whole digit leaving a generous portion still free which may then be applied to the preceding complete circle to create excellent fixation. (Fig. 1.) A tube gauze dressing completes the closure. The Steri-Strips may be applied along the length of the digit or in a crisscross
FIG. 1. Partial thickness skin graft on wound secured by Steri-Strips on fifth postoperative day.
fashion, whichever seems to give the best fixation of the graft. This method of skin graft fixation has been used in twenty-seven patients over the past year and we have found it to be satisfactory and reliable. All the patients were treated in the emergency room and seven of them were children. SUMMARY A simple and efficient method of skin graft fixation using Steri-Strips and which is applicable to patients seen in the Emergency Room especially children is described. 1.
REFERENCES
J. R. Partial-thickness skin grafting of finger-tip injuries. Lancet, 1: 705, 1967. 2. FISCHL, R. A. Skin grafting: a new technique. Brit. J. Plast. Surg., 18: 435, 1966. 3. DUNPHY, J. E. and JACKSON, D. S. Practical applications of experimental studies in the care of the primary closed wound. Am. J. Surg., 104: 273, 1962. 4. GOLDEN, T. G., LEVY, A. H., and O’CONNOR, W. T. Primary healing of skin wounds and incisions with a threadless suture. Am. J. Surg., 104: 603, 1962.
* Manufactured by the Minnesota Mining and Manufacturing Company, St. Paul, Minnesota. 474
SALAMON,
l’he Am&can
Journal
of Surgery