Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
J Wound Care. 2020 Dec 1;29(Sup12):S23-S27. doi: 10.12968/jowc.2020.29.Sup12.S23.
Tie-over dressing is the most frequently used technique of skin grafting. However, many deficiencies affecting the outcome have been reported. We hereby introduce a modified method, termed the 'extra-wound fixation technique', for skin dressing, and evaluate the complications and clinical outcomes.
In this retrospective cross-sectional study we analysed the medical records of patients treated between January 2012 and December 2017. All patients received full thickness skin grafts. Patients were divided equally into to groups: patients were treated using the extra-wound fixation technique, and the remaining, randomly selected patients treated using the traditional tie-over method. The extra-wound fixation technique uses the traditional tie-over dressing method followed by additional stitches made in healthy skin locating 0.5-1.0 cm laterally to the wound edge. The follow-up outcomes between the two groups were compared using the Chi-square test.
A total of 38 patients took part (19 patients in each group). The follow-up duration was 1-6 months. No raised edges were observed in any of the patients. Prolonged follow-up demonstrated that the grafted skin texture became soft with a thin layer of adipose tissue, and elasticity was gradually improved along with the regeneration of dermoelastic fibre. The colour was similar to the normal skin with a smooth surface. Compared with the traditional method, the extra-wound fixation technique significantly improved the survival of the grafted skin (p=0.008), reduced the risk of laceration of the skin (p=0.001), and eliminated crater rim-like appearances (p=0.020).
The extra-wound fixation technique could be used for different skin grafts and improve clinical outcomes compared with the traditional tie-over dressing method.
打包式加压包扎是最常用的植皮技术。然而，已有许多影响植皮效果的缺点被报道。我们在此引入一种改良的皮肤包扎方法，称为“额外伤口固定技术”，并评估其并发症和临床效果。
本回顾性横断面研究分析了 2012 年 1 月至 2017 年 12 月期间治疗的患者的病历。所有患者均接受全厚皮片移植。患者分为两组：一组采用额外伤口固定技术，另一组采用传统的打包式加压包扎技术。额外伤口固定技术是在传统的打包式加压包扎方法的基础上，在距伤口边缘 0.5-1.0cm 的健康皮肤上额外缝几针。使用卡方检验比较两组之间的随访结果。
共有 38 例患者参与（每组 19 例）。随访时间为 1-6 个月。所有患者均未见皮缘隆起。随访时间延长后发现，移植皮肤质地变软，有一层薄脂肪组织，弹性逐渐改善，真皮弹性纤维再生。其颜色与正常皮肤相似，表面光滑。与传统方法相比，额外伤口固定技术显著提高了移植皮片的成活率（p=0.008），降低了皮肤撕裂的风险（p=0.001），并消除了 crater rim-like appearances（p=0.020）。
额外伤口固定技术可用于不同的植皮术，并与传统的打包式加压包扎技术相比，可改善临床效果。
