Davis Mitchell, Baird Daniel, Hill Dane, Layher Heather, Akin Russell
Department of Internal Medicine, HCA Las Palmas Del Sol Healthcare, El Paso, Texas.
Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas.
Proc (Bayl Univ Med Cent). 2021 Jul 29;34(6):683-686. doi: 10.1080/08998280.2021.1953867. eCollection 2021.
Full-thickness skin grafts are a commonly used reconstructive method following Mohs micrographic surgery. The literature varies on the most appropriate methods of suturing and securing grafts as well as best practices to dress the graft postoperatively. Our objective was to review various approaches to management of full-thickness skin grafts, including suturing the graft, securing the graft, and topical emollient use on the graft postoperatively. It was found that absorbable sutures, plain gut, provide preferable outcomes with full-thickness skin grafts. The tie-over bolster is the most-used method for securing skin grafts after placement, although several other methods have demonstrated efficacy, including the polyurethane foam, sandwich, and quilting suture methods. While various topical emollients are used in the immediate postoperative period, plain white petrolatum is the least likely to form allergic contact dermatitis.
全厚皮片移植是莫氏显微外科手术后常用的重建方法。关于缝合和固定皮片的最合适方法以及术后包扎皮片的最佳做法，文献中的说法不一。我们的目的是回顾全厚皮片移植的各种处理方法，包括皮片缝合、固定以及术后在皮片上使用外用润肤剂。研究发现，可吸收缝线（普通肠线）用于全厚皮片移植时效果更佳。移植后固定皮片最常用的方法是打包加压包扎，不过其他几种方法也已证明有效，包括聚氨酯泡沫法、三明治法和缝合法。虽然术后即刻会使用各种外用润肤剂，但纯白凡士林引发过敏性接触性皮炎的可能性最小。
