Uses of Coban self-adherent wrap in management of postburn hand grafts: case reports

Coban wrap is a durable, elastic, self-adherent gauze that applies snugly without loosening. Coban does not stick to underlying tissue, making it excellent for early postoperative management of split- and full-thickness hand grafts. The wrap protects new grafts and decreases postoperative edema, permitting earlier mobility and facilitating accurate measurements for fitting of pressure garments. Wounds are judged suitable for Coban when the grafts are largely adherent and vascularized. Coban can be wrapped (1) directly over the graft, (2) over an ointment/adaptic dressing, or (3) over gauze padding for extra protection, or use as a "soft splint." Because of its inherent elasticity, Coban can be used to passively encourage desirable joint positions. The wrap is changed daily, and family members readily learn its use. Coban appears to encourage early, protected, active range of motion and early use of custom-fit pressure garments.