Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study

2021 ◽  
Vol 8 (2) ◽  
pp. 58-61
Author(s):  
Dr. Ganesh Chaudhari ◽  
Dr. Satish Sonawane

Background: Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Materials & methods: A comparative study conducted in 30 patients with post burn neck contracture at Dr. Vasantrao Pawar Medical College, Nashik, during January 2015 to December 2020. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p<0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion: Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake.

Author(s):  
Domenico Pagliara ◽  
Maria Lucia Mangialardi ◽  
Stefano Vitagliano ◽  
Valentina Pino ◽  
Marzia Salgarello

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.


2001 ◽  
Vol 46 (1) ◽  
pp. 87-88 ◽  
Author(s):  
Bishara S. Atiyeh ◽  
Georges Ghanimeh ◽  
Imad L. Kaddoura ◽  
John Ioannovich ◽  
Christian A. Al-Amm

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