TO TIE OR NOT TO TIE – OVER FULL THICKNESS SKIN GRAFTS: A PROSPECTIVE COMPARATIVE STUDY

Hiveen Hannan* and Firas Melhem

ABSTRACT

Background: Various techniques are employed for the fixation and management of skin grafts, highlighting the growing demand for a method that reduces the patient's recovery time, reduces the burden of frequent dressings on both medical professionals and patients, and ensures the secure attachment of the skin graft. Moreover, there is a need for a skin graft that is suitable in terms of color, size, and circumference, with no conclusive evidence indicating the superiority of any particular method. Objective: This study aims to assess the efficacy of compression dressing in comparison to traditional dressing for full-thickness skin grafts in terms of the duration of complete healing and the occurrence of complications and Methods: Following patient consent, thorough wound debridement was performed, a full-thickness graft was then performed and a dressing was applied. Patients were randomly divided into two groups: the first group received a compression bandage with the skin graft, while the second group did not. Patients were monitored on the fifth day postsurgical to inspect the dressing and confirm graft viability. A subsequent follow-up took place a month later to ensure graft success and assess any complications. Data was collected, entered into SPSS Version 26, and analyzed accordingly. Results: The study involved 42 patients from the Reconstructive Surgery Department and Clinic at Tishreen University Hospital, aged between 23-51 years. Sources of skin loss varied among patients, including malignancies (8 patients, 19%), post-surgical complications (21 patients, 50%), and burn injuries (13 patients, 31%). The mean physical loss size among patients was 9.4 ± 2.8 cm2. Graft failure occurred in 8 patients (19%) within 5 days postsurgical, with 2 (9.5%) from the first group and 6 (28.5%) from the second group. One-month later, 3 patients experienced graft failure, with 2 from the second group and 1 from the first group. The areas of graft failure were all on the face in the first group and in diversified locations in the second group. The mean recovery time was 18.4 ± 4.5 days, with the first group recovering in 17.3 ± 5 days and the second group in 20.1 ± 6.7 days. Infections were the most common complication (8 patients, 19%), followed by hematoma (5 patients, 12%), seroma (patients, 25%), graft was observed in 4 patients (9.5%). Conclusions: It is necessary to make an approach for each physical loss that requires grafting and use the appropriate bandage according to the preference between the compression bandage and the regular bandage. Both types of dressings showed good effectiveness in preserving the graft , but the location of the physical loss, the size of the physical loss, and the grafting still have the first role in determining the type of dressing.

Keywords: Skin grafts compression dressing, Regular dressing, Full-thickness skin grafts.