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Tie-over bolster dressings may not be necessary to secure small full thickness skin grafts
J A Langtry1, P Kirkham, I C Martin
1Department of Dermatology, Sunderland Royal Hospital, United Kingdom.
Background:
The accepted method for securing full thickness skin grafts (FTSG) is with a tie-over bolster dressing, with or without basting sutures. We question the need for tie-over bolster dressings for small FTSGs.
Objective:
We describe our method of FTSG reconstruction and the outcome in a consecutive series.
Methods:
Thirty patients with surgical defects following tumour excision from the face24, scalp1, ear2, and finger3 ranging in diameter from 8 to 45 mm (mean 20 mm) were reconstructed with a FTSG. Interrupted monofilament nylon perimeter sutures only were used, with antibiotic ointment at the wound edge with either a light dressing or no dressing.
Results:
A series of 30 FTSG secured without a tie-over bolster dressing or basting sutures is described, all with good to excellent long term results. In two cases there was early superficial necrosis of the graft, but ultimately 100% graft take.
Conclusion:
We have found tie-over bolster dressings and basting sutures to be unnecessary in our series of small FTSG. This technique saves time and material and minimizes handling of the graft.