New Dressing Technique for Free Skin Graft with Transparent Adhesive Tape

DOI Web Site 5 References
  • Kawasaki Reiko
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Kamei Kyoko
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Yasukawa Fumiko
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Kato Shiori
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Hosokawa Chisato
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Saito Tomoko
    Division of Dermatology and Allergology, National Kyushu Medical Center
  • Imayama Shuhei
    Division of Dermatology and Allergology, National Kyushu Medical Center

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Other Title
  • 粘着フィルムによる植皮片固定法
  • ネンチャク フィルム ニ ヨル ショクヒヘン コテイホウ

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Description

The “tie-over” dressing has been employed to closely fix grafted skin to the recipient site for one week after surgery. However, occasional dislodge, hematoma or pressure necrosis of the grafted skin is veiled until the dressing (usually stuffed with cotton) is removed one week later. At that time, the donor skin cannot be rescued. To permit a direct look and immediate rescue, we utilized a transparent adhesive film (made of polyurethane, TegadermTM , USA) for the dressing of grafted skin instead of the “tie-over” and evaluated the efficacy and demerits of the transparent immobilization technique. Between October of 2005 and September of 2006, 10 patients with skin-graft surgeries (6 full-thickness and 4 split-thickness) successive to the resection of malignant tumors (basal cell carcinomas, Bowen’s disease, dermatofibrosarcoma protuberans and breast cancer) and of tattoos, and skin-graft surgeries for prolonged leg ulcers (chronic venous insufficiency and polyarteritis nodosa) gave informed consent and treated with our new surgical procedure. Follow-up studies revealed 6 excellent results with complete adhesion, 2 fair results with <10% dislodge, and 2 poor results with <30% dislodge due to hematoma. We experienced no compression necrosis. In cases with successful outcomes, the grafted areas were free of scarring, and their appearance resembled that of the surrounding normal skin, particularly of the face. In contrast, the fair and poor results exhibited scars where impaired adhesion of the transparent tape had resulted from an uneven surface of the recipient site or from continuous movement of the grafted area during daily activity.

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