Yen Ya-Hui, Lin Chih-Ming, Hsu Honda, Chen Ying-Chen, Chen Yi-Wen, Li Wan-Yu, Hsieh Chia-Nan, Huang Chieh-Chi
Division of Plastic Surgery and.
Department of Nursing, Dalin Tzu Chi Hospital, Dalin, Taiwan.
Ann Plast Surg. 2018 Jun;80(6):616-621. doi: 10.1097/SAP.0000000000001432.
The traditional method of skin graft fixation is with tie-over bollus dressing. The use of splints in the extremities for skin graft fixation is a common practice. However, these splints are heavy and uncomfortable and contribute considerably to our overall medical waste. Hydrofiber (Aquacel Extra) has a strong fluid absorption property and fixates well to the underlying wound once applied. In this study, we used hydrofiber for fixation, avoiding the use of splints after skin grafting.
A total of 56 patients reconstructed with split-thickness skin graft that was fixated only with hydrofiber between March 2015 and March 2016 were included in this retrospective study.
There were 44 men and 12 women with a mean age of 61 ± 18 years. The defect size ranged from 1 × 1 cm for fingertips to 30 × 12 cm for lower limb defects. The average defect size was 61 ± 78 cm. The mean skin graft take was 96% ± 6%. Because splints were not required, we saved around 48 kg of medical waste over the space of 1 year.
The use of hydrofiber for skin graft fixation was effective and technically very simple. Splints were not required with this method, decreasing the medical waste created and increasing patient comfort. We suggest that this is an excellent alternative for skin graft fixation while at the same time decreasing our carbon footprint as surgeons.
传统的皮肤移植固定方法是使用包扎敷料。在四肢使用夹板进行皮肤移植固定是一种常见的做法。然而，这些夹板笨重且令人不适，并且对我们的整体医疗废物产生有相当大的影响。水凝胶纤维（爱康肤银敷料）具有很强的吸液性能，一旦应用就能很好地固定在下方的伤口上。在本研究中，我们使用水凝胶纤维进行固定，避免在皮肤移植后使用夹板。
本回顾性研究纳入了2015年3月至2016年3月期间共56例仅用水凝胶纤维固定的中厚皮片移植重建患者。
有44名男性和12名女性，平均年龄为61±18岁。缺损大小从指尖的1×1厘米到下肢缺损的30×12厘米不等。平均缺损面积为61±78平方厘米。皮肤移植的平均成活率为96%±6%。由于不需要夹板，我们在1年的时间里节省了约48千克的医疗废物。
使用水凝胶纤维进行皮肤移植固定是有效的，而且技术上非常简单。这种方法不需要夹板，减少了产生的医疗废物并提高了患者的舒适度。我们认为这是皮肤移植固定的一种极佳替代方法，同时作为外科医生也减少了我们的碳足迹。
