J Korean Soc Plast Reconstr Surg.
1998 Jul;25(5):928-933.
New method of tie-over dressing
Abstract
- The most important basic requirements for successful skin grafting are the accurate approximation of the edge of the skin graft to that of the wound and the application of even pressure to the graft by a carefully designed dressing. Pressure dressing is indicated for the protection of the graft and the prevention of shearing between the graft and its bed. One of the most widely used methods of pressure dressing is tie-over dressing. The traditional technique is based on the application of long silk sutures along the margin of the graft that are tied over bolus of antibiotics oint-impregnated nonadherent fluffed gauze. With the traditional tie-over dressing, it is impossible to inspect the graft bed for possible hematoma and seroma during the application of dressing. So we adopted another modification of the previously described tie-over dressing methods. From January 1997 to July 1997, we had performed 27 skin graft surgeries and 8 subdermal shavings in 35 patients with our new method of tie-over dressing. We can apply even pressure to the grafts by twisting the long silk sutures instead of typing.In comparison with the plethora of devices and techniques described previously in tie-over dressing construction, our technique offers simplicity and reliable fixation of the graft to the bed and allows further adjustment of the dressing by individual tightening of the threads. Other particularly attractive features are the ability to inspect the graft at any time with little difficulty and the reapplicability of tie-over dressing with the remaining long threads if needed.
