Cheng Li-Fu, Lee Jiunn-Tat, Chou Trong-Duo, Chiu Tai-Feng, Sun Tzong-Bor, Wang Chien-Hsing, Chien Sou-Hsin, Wang Hsian-Jenn
Division of Plastic Surgery, Department of Surgery, Buddhist Tzu-Chi General Hospital, 707, Sec. 3, Chung-Yang Road, Hualien 970, Taiwan, ROC.
Burns. 2006 Mar;32(2):212-5. doi: 10.1016/j.burns.2005.08.026. Epub 2006 Jan 31.
We derived a dressing using elastic rubber bands to tie over the skin graft. This is a simple, easy to perform, timesaving, inexpensive and reliable method for applying pressure over the skin graft compared with traditional methods. Between September 2002 and August 2004, we have used the present dressing technique in 35 patients with 36 grafts in various parts of the body. We chose this method, because of some anatomic areas, such as back, and buttock, which are frequently quite difficult to maintain pressure dressings in place, minimal movement can cause the skin graft to dislodge. The elastic rubber bands, rather than threads, are used as tie-over. Such a dressing permits expansion and contraction, providing a dynamic quality in the most difficult anatomic locations. The patient group consisted of 23 males and 12 females. The age ranged from 34 to 82 years (mean 52.4 years). Defect size ranged from 3x2.5 to 30x20 cm2 (mean 11.2x7.0 cm2 in size). The average follow-up was 5.8 months (range: 1-12 months). Among the 36 grafts in our study, all grafts except four showed good to excellent results. The mean graft successful rate is 88%. With our procedure no hematoma formation or shearing force (except one case) occurred in this group of patients during the phase of revascularization, there was, hence, good fixation of the graft by the "tie-over" dressing using elastic rubber bands compared with conventional tie-over dressing, especially in skin grafts of the back site of body and at large graft area. However, it is not suitable for the potentially infectious granulation beds, especially near joint area.
我们采用弹性橡皮筋制作了一种敷料，用于绑扎在皮肤移植片上。与传统方法相比，这是一种简单、易于操作、省时、廉价且可靠的对皮肤移植片施加压力的方法。在2002年9月至2004年8月期间，我们对35例患者身体不同部位的36处移植片使用了这种敷料技术。我们选择这种方法是因为在一些解剖部位，如背部和臀部，很难将加压敷料固定在位，极小的移动都可能导致皮肤移植片移位。使用弹性橡皮筋而非线作为绑扎物。这样的敷料允许扩张和收缩，在最难处理的解剖部位提供了动态的特性。患者组包括23名男性和12名女性。年龄范围为34至82岁（平均52.4岁）。缺损面积范围为3×2.5至30×20平方厘米（平均大小为11.2×7.0平方厘米）。平均随访时间为5.8个月（范围：1至12个月）。在我们研究的36处移植片中，除4处外，所有移植片均显示出良好至优异的效果。移植片的平均成功率为88%。采用我们的方法，在这组患者的血管再生阶段未发生血肿形成或剪切力（除1例），因此，与传统绑扎敷料相比，使用弹性橡皮筋的“绑扎”敷料对移植片的固定良好，尤其是在身体背部的皮肤移植片和大面积移植片的情况下。然而，它不适用于可能感染的肉芽创面，尤其是靠近关节部位。
