Management of full-thickness skin grafts

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Full-thickness skin grafts are essential for reconstruction after Mohs surgery.
• Optimal graft management techniques, including suturing, securing, and postoperative dressing, remain debated.
• Evidence-based guidelines for these practices are needed.

Purpose of the Study:

• To review and synthesize current literature on the management of full-thickness skin grafts.
• To evaluate different suturing techniques, graft-securing methods, and topical emollient applications.
• To identify best practices for postoperative graft care.

Main Methods:

• Systematic literature review of studies on full-thickness skin graft management.
• Analysis of techniques for graft suturing, fixation, and postoperative topical treatments.
• Comparison of outcomes associated with different methods.

Main Results:

• Absorbable sutures, specifically plain gut, are associated with preferable outcomes.
• The tie-over bolster is a common method for securing grafts, with alternatives like polyurethane foam, sandwich, and quilting sutures also showing efficacy.
• Plain white petrolatum is the least likely topical emollient to cause allergic contact dermatitis.

Conclusions:

• Plain gut sutures represent an optimal choice for full-thickness skin grafts.
• Various effective methods exist for securing skin grafts, with the tie-over bolster being widely used.
• Plain white petrolatum is recommended as a safe postoperative emollient to prevent adverse skin reactions.