Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Division of Dermatology, Niigata Cancer Center Hospital, Niigata, Japan.
J Dermatol. 2017 Nov;44(11):1317-1319. doi: 10.1111/1346-8138.13916. Epub 2017 May 30.
Tie-over bolster dressing after skin grafting can prolong operative time, and cause hematoma and seroma formation because of uneven pressure application. To describe the possibility of discontinuing the use of tie-over dressing, we carried out a retrospective comparative study of patients who underwent skin grafting at an institution between January 2009 and December 2014. We investigated and compared the take rate, healing period, wound infection rate and hematoma formation rate for the tie-over dressing group and the non-tie-over dressing group. Among 266 patients, 148 and 118 patients were included in the tie-over dressing group and non-tie-over dressing group, respectively. There were no significant differences between the take rate, healing period, wound infection rate and hematoma formation rate for the two groups. Multivariate analysis showed that the complete graft take rate was not significantly influenced by tie-over dressing, age, sex, graft site, graft procedure and skin graft diameter. Although the use of tie-over dressing might remain necessary on sites with a free margin, including the eyelids, lips or nostrils, because of the difficulty in using tape fixation, the present study showed that alternative dressing with polyurethane foam is also useful in most cases of skin grafting.
植皮术后使用打包加压固定可能会延长手术时间，而且由于压力分布不均匀，还会导致血肿和血清肿形成。为了探讨是否可以停止使用打包加压固定，我们对 2009 年 1 月至 2014 年 12 月期间在我院行植皮术的患者进行了回顾性对比研究。我们调查并比较了打包加压固定组和非打包加压固定组的植皮成活率、愈合时间、伤口感染率和血肿形成率。在 266 例患者中，分别有 148 例和 118 例患者纳入打包加压固定组和非打包加压固定组。两组的植皮成活率、愈合时间、伤口感染率和血肿形成率均无显著差异。多因素分析显示，打包加压固定对完全植皮成活率无显著影响，而年龄、性别、植皮部位、植皮方式和皮片直径有影响。尽管由于使用胶带固定困难，对于包括眼睑、嘴唇或鼻孔在内的游离缘部位可能仍需要使用打包加压固定，但本研究表明，在大多数植皮情况下，使用聚氨酯泡沫替代加压固定也是有用的。
