A novel method of skin graft fixation using adhesive hydrofiber foam.

OBJECTIVE: Conventional skin graft fixation uses a tie-over bolus dressing with splint fixation. However, splints are highly uncomfortable and contribute considerably to medical waste. Previous study has shown positive results using hydrofiber for skin graft fixation. The aim of this study was to assess the effectiveness of using adhesive hydrofiber foam for skin graft fixation. METHOD: In this retrospective study, patients reconstructed with split-thickness skin graft that was fixated only with adhesive hydrofiber foam from April 2017 until April 2019 were included. RESULTS: A total of 44 patients took part, of whom 32 were male and 12 female, with a mean age of 56±19 years. The mean operative time was 77.5±91 minutes. The average defect size was 42±37cm2. The mean skin graft take was 97±5%. The mean length of hospital admission after skin grafting until discharge was 8.5±9.2 days. Excluding those patients undergoing other procedures at the same time as the skin graft gave a total of 34 patients. Their mean operative time was 32±20 minutes, and mean length of hospital stay after skin grafting was 4.0±4.7 days. CONCLUSION: Adhesive hydrofiber foam for skin graft fixation was technically very easy to apply, resulting in a waterproof, non-bulky, secure dressing. Splints were not required. Patients were allowed to mobilise. This method resulted in increased patient comfort and decreased medical waste. From these findings, we believe that this is an extremely simple and effective method of skin graft fixation.

Skin Graft Fixation Using Hydrofiber (Aquacel® Extra).

BACKGROUND: The traditional method of skin graft fixation is with tie-over bollus dressing. The use of splints in the extremities for skin graft fixation is a common practice. However, these splints are heavy and uncomfortable and contribute considerably to our overall medical waste. Hydrofiber (Aquacel Extra) has a strong fluid absorption property and fixates well to the underlying wound once applied. In this study, we used hydrofiber for fixation, avoiding the use of splints after skin grafting. METHODS: A total of 56 patients reconstructed with split-thickness skin graft that was fixated only with hydrofiber between March 2015 and March 2016 were included in this retrospective study. RESULTS: There were 44 men and 12 women with a mean age of 61 ± 18 years. The defect size ranged from 1 × 1 cm for fingertips to 30 × 12 cm for lower limb defects. The average defect size was 61 ± 78 cm. The mean skin graft take was 96% ± 6%. Because splints were not required, we saved around 48 kg of medical waste over the space of 1 year. CONCLUSIONS: The use of hydrofiber for skin graft fixation was effective and technically very simple. Splints were not required with this method, decreasing the medical waste created and increasing patient comfort. We suggest that this is an excellent alternative for skin graft fixation while at the same time decreasing our carbon footprint as surgeons.