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

Tie-over bolster dressing has been the gold standard for full-thickness skin graft (FTSG) immobilization. However, in complex hand reconstruction, which involves multiple fingers, the anatomy is relatively complex, and there are many curvatures and irregular surfaces. Therefore, complex hand reconstruction is usually time-consuming if tie-over is applied to the whole hand, including individual fingers. We present a simple and effective technique to secure the FTSG over the fingers with a self-adherent wrap elastic bandage (3M Coban) without the need for tie-over dressing. Fifty-three patients with a total of 74 hands with burn deformities were treated with our proposed method. All the skin grafts over the fingers had taken well without obvious hematoma formation, necrosis, or infection. The mean follow-up time was 27.82 months (range, 1-78 mo). This novel method could decrease the operation time with reliable results.