Simple and Effective Tie-over Dressing in Split Thickness Skin Graft

Park, Dong Ha; Kim, Joo Hyoung; Park, Myong Chul; Lee, Il Jae

Abstract

Immobilization of skin graft is essential in split thickness skin graft. A common practice to ensure immobilzation is tie-over dressing. Tie-over dressing is used to secure skin graft and to avoid complications such as fluid accumulation and hematoma formation. But the traditional technique of tie-over dressing is a time-consuming tedious task. Various modifications of this method have been developed. But almost all the methods required the silk tie as well as special devices. We designed simple and effective immobilization method of skin graft that is neither threads nor securing devices are required. After skin graft is applied to recipient bed, skin staples are used to tack the graft. Vaseline gauze is applied over the graft. A fluffy gauze bolus is placed over the vaseline gauze and wrapped around the bolus with mesh gauze. The skin staples are used to secure the free ends on the bolus dressing applying proper tension. These free ends of the mesh gauze, acting like two-dimensional threads, put a pressure on the bolus dressing and the graft. This method has been used in 30 patients and has proven satisfactory.