A New Loop Suture Tie-Over Technique for Skin Graft Dressings

2002 ◽  
Vol 27 (2) ◽  
pp. 129-133 ◽  
Author(s):  
A. MISRA ◽  
H. J. C. R. BELCHER

Skin grafting is a well established technique for reconstructing areas of skin loss or excision in the hand. Traditional tie-over sutures often require operator assistance, do not allow adequate control when knotting and may cause unnecessary trauma to the graft when removed. We describe a new looped suture tie-over technique to secure and fix the graft dressings that is simple, quick, allows better knot-tying control and can be removed atraumatically.

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Shalawaty . ◽  
Jan Ngantung ◽  
Hilman Limpeleh

Abstract: In dealing with an injury caused by trauma or disease, we expected to restore anatomical integrity and function. In reality, not all wounds can be closed primarily, there are too extensive skin loss requiring tissue cover to cope. One option to close a wound by doing skin grafting. This research use descriptive cross sectional study using a questionnaire to co-assistant level of knowledge in the department of Prof.Dr. R.D. Kandou. This study aims to reveal the knowledge of co-assistant to skin graft. The sample amount to 96 co-assistant. The results show that most of the co-assistant knowledgeable well with the percentage of 55,2% Keywords: co-assistant, knowledge, skin graft.     Abstrak: Dalam menangani suatu luka akibat trauma atau penyakit, kita diharapkan dapat mengembalikan integritas anatomi maupun fungsi. Pada kenyataannya tidak semua luka dapat ditutup secara primer, ada yang karena kehilangan kulitnya terlalu luas membutuhkan jaringan penutup untuk mengatasinya. Salah satu pilihan untuk menutup luka tersebut dengan melakukan tindakan skin grafting. Penelitian ini menggunakan metode deskriptif cross sectional dengan menggunakan kuesioner tingkat pengetahuan kepada coassistant di RSUP Prof.Dr. R.D. Kandou. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan co-assistant terhadap skin graft. Sampel berjumlah 96 co-assistant. Hasil penelitian menunjukkan bahwa sebagian besar co-assistant berpengetahuan baik dengan persentase 55,2% Kata kunci: co-assisten, pengetahuan, skin graft.


2021 ◽  
Vol 7 ◽  
pp. 2513826X2110084
Author(s):  
Weston Thomas ◽  
Kevin Rezzadeh ◽  
Kristie Rossi ◽  
Ajul Shah

Introduction: Skin graft reconstruction is a common method of providing wound coverage. Rarely, skin grafting can be associated with the development of squamous cell carcinoma (SCC) in the graft donor site. Case Report: The patient is a 72-year old male with a 15-year history of bilateral hip wounds. He underwent a multitude of treatments previously with failed reconstructive efforts. After presenting to us, he underwent multiple debridements and eventual skin grafting. Within 4 weeks of the final skin graft, a mass developed at the skin graft donor site at the right thigh. Excisional biopsy returned a well differentiated keratinizing SCC. Discussion/Conclusion: This case demonstrates the acute presentation of SCC in a patient following a skin graft without known risk factors. The purpose of this unique case report is to highlight a very rare occurrence of SCC at a skin graft donor site.


Author(s):  
Gaozhong Hu ◽  
Peng Zhang ◽  
Yan Chen ◽  
Zhiqiang Yuan ◽  
Huapei Song

Abstract Background Burns are common injuries associated with high disability and mortality. In recent years, Meek micrografting technique has been gradually applied for the wound treatment of severe burns. However, the efficacy of two-stage Meek micrografting in patients with severe burns keeps unclear. Methods The data of eligible patients with severe burns who were admitted to Southwest Hospital of the Third Military Medical University from January 2013 to December 2019 were retrospectively analysed. The patients were divided into two groups according to the Meek micrografting method: one-stage skin grafting (group A) and two-stage skin grafting (group B). The baseline data, survival rate of skin graft, length of hospital stay, treatment costs, laboratory data and cumulative survival were statistically analysed. Results 127 patients (91 in group A and 36 in group B) were included in the study. There were no significant difference in the baseline data, the length of hospital stay and treatment costs between the two groups. The survival rate of skin graft was higher in group B. Total protein and albumin level, platelet count in group B were superior to those in group A, while there were no difference in other laboratory data (prealbumin, serum creatinine, urea nitrogen, cystatin C, blood cultures, wound exudate cultures) and cumulative survival between the two groups. Conclusion Our results demonstrated that staged Meek micrografting could improve the survival rate of skin graft, by reducing the risks of hypoproteinaemia, hypoalbuminemia and low platelet counts after adequate resuscitation.


2010 ◽  
Vol 76 (2) ◽  
pp. 172-175 ◽  
Author(s):  
David E. Tribble

Skin grafting of traumatic finger amputations and concave raw surfaces poses special problems for skin grafting. In grafting finger amputations, oozing of blood tends to form a film of blood separating the graft from the raw amputation site. In concave raw surfaces, the skin must be made to conform to the concave surface. A technique of secure fixation of the graft allowing for frequent irrigation of the graft affords a better chance for a good skin graft take.


2005 ◽  
Vol 30 (2) ◽  
pp. 194-198 ◽  
Author(s):  
A. LAZAR ◽  
P. ABIMELEC ◽  
C. DUMONTIER

A retrospective study of 13 patients assessed the use of a full thickness skin graft for nail unit reconstruction after total nail unit removal for nail bed malignancies. No failures of the graft were observed and no patient had recurrence of the malignant tumour at 4 year follow-up. Full thickness skin grafting is a simple procedure which provides a good cosmetic outcome and does not produce significant donor site morbidity.


2020 ◽  
Vol 41 (4) ◽  
pp. 892-899
Author(s):  
Jinfeng Zhou ◽  
Youcai Zhao ◽  
Wengbo Yang ◽  
Qianming Du ◽  
Jun Yin ◽  
...  

Abstract After transplantation, skin grafts contract to different degrees, thus affecting the appearance and function of the skin graft sites. The exact mechanism of contracture after skin grafting remains unclear, and reliable treatment measures are lacking; therefore, new treatment methods must be identified. Many types of centripetal contraction forces affect skin graft operation, thus leading to centripetal contracture. Therefore, antagonizing the centripetal contraction of skin grafts may be a feasible method to intervene in skin contracture. Here, the authors propose the first reported mechanical stretching method to address contracture after skin grafting. A full-thickness skin graft model was established on the backs of SD rats. The skin in the experimental group was stretched unilaterally or bidirectionally with a self-made elastic stretching device, whereas the skin was non-stretched in the control group. The rats were sacrificed 2 weeks after stretching. The area, length, and width of the skin were measured. The grafts were cut and fixed with formalin. Routine paraffin sections were stained with hematoxylin-eosin, picric acid-Sirius red, Victoria blue, and anti-alpha-smooth muscle actin (SMA). Mechanical stretching made the graft lengthen in the direction of the stress and had an important influence on collagen deposition and alpha-SMA expression in the graft. This method warrants further in-depth study to provide a basis for clinical application.


2020 ◽  
Vol 48 (2) ◽  
pp. 93-100
Author(s):  
John E Greenwood

After major burn injury, once survival is achieved by the immediate excision of all deep burn eschar, we are faced with a patient who is often physiologically well but with very extensive wounds. While very early grafting yields excellent results after the excision of small burns, it is not possible to achieve the same results once the wound size exceeds the available donor site. In patients where 50%–100% of the total body surface area is wound, we rely on serial skin graft harvest, from finite donor site resources, and the massive expansion of those harvested grafts to effect healing. The result is frequently disabling and dysaesthetic. Temporisation of the wounds both passively, with cadaver allograft, and actively, with dermal scaffolds, has been successfully employed to ameliorate some of the problems caused by our inability to definitively close wounds early. Recent advances in technology have demonstrated that superior functional and cosmetic outcomes can be achieved in actively temporised areas even when compared with definitive early closure with skin graft. This has several beneficial implications for both patient and surgeon, affecting the timing of definitive wound closure and creating a paradigm shift in the care of the burned patient.


2016 ◽  
Vol 4 ◽  
pp. 1-11 ◽  
Author(s):  
Yoshitaka Kubota ◽  
Nobuyuki Mitsukawa ◽  
Kumiko Chuma ◽  
Shinsuke Akita ◽  
Yoshitaro Sasahara ◽  
...  

Abstract Background Early excision and skin grafting are commonly used to treat deep dermal burns (DDBs) of the dorsum of the hand. Partial-thickness debridement (PTD) is one of the most commonly used procedures for the excision of burned tissue of the dorsum of the hand. In contrast, full-thickness debridement (FTD) has also been reported. However, it is unclear whether PTD or FTD is better. Methods In this hospital-based retrospective study, we compared the outcomes of PTD followed by a medium split-thickness skin graft (STSG) with FTD followed by a thick STSG to treat a DDB of the dorsum of the hand in Japanese patients. To evaluate postoperative pigmentation of the skin graft, quantitative analyses were performed using the red, green, and blue (RGB) and the hue, saturation, and brightness (HSB) color spaces. We have organized the manuscript in a manner compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results Data from 11 patients were analyzed. Six hands (five patients) received grafts in the PTD group and eight hands (six patients) received grafts in the FTD group. Graft take was significantly better in the FTD group (median 98 %, interquartile range 95–99) than in the PTD group (median 90 %, interquartile range 85–90) (P < 0.01). Quantitative skin color analyses in both the RGB and HSB color spaces showed that postoperative grafted skin was significantly darker than the adjacent control area in the PTD group, but not in the FTD group. Conclusions There is a possibility that FTD followed by a thick STSG is an option that can reduce the risk of hyperpigmentation after surgery for DDB of the dorsum of the hand in Japanese patients. Further investigation is needed to clarify whether the FTD or the thick STSG or both are the factor for the control of hyperpigmentation.


Author(s):  
L Pennasilico ◽  
C Di Bella ◽  
R Botto ◽  
E Murgia ◽  
V Riccio ◽  
...  

In human medicine, skin grafting is an innovative surgical technique widely used in reconstructive surgery to repair skin loss. This case evaluated the effectiveness of a treatment with dermal micro-grafting obtained through the Rigenera<sup>®</sup> technology in a chronic open wound resulting from a suture dehiscence of a limb amputation in a cat. Significant differences were observed between the aesthetic aspects of the injury using traditional treatments (cleaning and curettage) and the regenerative technology. The results showed that the healing periods were significantly reduced after the Rigenera<sup>®</sup> treatment and that, moreover, a perfect skin status and a complete reduction in the wound area (100%) were achieved in one month. Given these results, Rigenera<sup>®</sup> has proven to be a simple yet highly effective method in the treatment of inactivated chronic wounds.


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