A Novel Method for Full-thickness Skin Graft Fixation Over the Fingers in Complex Hand Reconstruction

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Burn Care

Background:

• Tie-over bolster dressings are standard for immobilizing full-thickness skin grafts (FTSG).
• Complex hand anatomy presents challenges for traditional FTSG immobilization techniques.
• Applying tie-over dressings to multiple fingers is time-consuming and complex.

Purpose of the Study:

• To introduce a simpler, effective method for FTSG immobilization on fingers using self-adherent wrap elastic bandages.
• To evaluate the efficacy and reliability of this novel technique in complex hand reconstruction.

Main Methods:

• A technique utilizing self-adherent wrap elastic bandages (3M Coban) was developed to secure FTSGs on fingers.
• This method eliminates the need for traditional tie-over bolster dressings.
• The technique was applied to 53 patients (74 hands) with burn deformities.

Main Results:

• Successful graft take was observed in all treated fingers.
• No significant hematoma formation, necrosis, or infection occurred.
• The mean follow-up period was 27.82 months, demonstrating durable results.

Conclusions:

• Self-adherent wrap elastic bandages offer a reliable and efficient alternative to tie-over dressings for FTSG on fingers.
• This technique simplifies the surgical process and reduces operative time in complex hand reconstructions.
• The method yields excellent graft survival rates and patient outcomes.