Davenport M, Daly J, Harvey I, Griffiths R W
Department of Plastic and Reconstructive Surgery, Northern General Hospital, Sheffield.
Br J Plast Surg. 1988 Jan;41(1):28-32. doi: 10.1016/0007-1226(88)90140-3.
It has been taught that the bolus tie-over "pressure" dressing is essential for the successful "take" of full thickness skin grafts. This was tested in a prospective randomised trial in which 40 full thickness grafts were either managed with the conventional bolus dressing, or alternatively with quilting sutures and no dressing. Whether under local or general anaesthesia there was only one total graft failure from haematoma (tie-over bolus group) and one partial graft failure from haematoma (quilted group). Sixty-five per cent. of all grafts were performed by junior surgical trainees. The bolus tie-over "pressure" dressing does not appear essential for full thickness skin graft survival in the areas of the head and neck studied.
一直以来都认为，团状包扎“加压”敷料对于全厚皮片移植的成功“存活”至关重要。在一项前瞻性随机试验中对此进行了测试，该试验中40块全厚皮片要么采用传统的团状敷料处理，要么采用缝合法且不使用敷料。无论是在局部麻醉还是全身麻醉下，仅出现1例因血肿导致的全层移植失败（团状包扎组）和1例因血肿导致的部分移植失败（缝合法组）。所有移植手术中有65%是由初级外科实习生完成的。在所研究的头颈部区域，团状包扎“加压”敷料对于全厚皮片存活似乎并非必不可少。
