Through and Through Mattress Suturing Versus Tie Over Dressing in Full Thickness Skin Graft Reconstruction.
Abstract
Background: The successful acceptance of a skin graft by the wound bed hinges on direct contact to facilitate optimal nutrient diffusion. Immobilization of the graft is crucial in preventing seroma formation and rupture. Among the techniques employed for stabilization is through and through mattress suturing, which entails placing basic stitches on the graft's surface and creating a cross stitch between the graft's center and the recipient bed. This method enhances stability, adhesion, and ensures proper integration with the recipient bed.
Aim: This study seeks to assess the efficacy of compression dressing compared to through and through mattress suturing in stabilizing full-thickness skin grafts concerning complete healing time and complication incidence.
Materials and Methods: Following patient consent, thorough wound bed debridement was conducted, followed by full-thickness skin grafting and dressing application. Patients were randomized into two groups: one receiving a Tie-Over dressing after full-thickness skin grafting, and the other undergoing quilting sutures. The application of sutures, in terms of number and type, was tailored to individual tissue loss characteristics. Post-dressing application, patients underwent a follow-up on the fifth postoperative day to assess graft vitality. Subsequent follow-ups occurred one-month post-surgery to confirm graft success and detect complications.
Results: The study encompassed 36 patients aged 19-63 years. Of these, 21 were male (58.3%) and 15 were female (41.7%). Surgical material loss was the primary cause for procedures in 16 patients, with the face and neck being the most frequent injury locations in 19 patients. The average material loss area for patients was 6.8 ± 0.5 cm2, and procedure duration ranged between 40-60 minutes. Graft failure within 5 days’ post-surgery was observed in 6 patients from the first group and 2 from the second group. However, after one month, graft failure occurred in 3 patients from the first group and 2 from the second group. The average healing time was 17.2 ± 2.8 days. Hospital stay averages were 5.9 days ± 1.2 for the first group and 5.1 days ± 0.9 for the second. Patients in the first group required dressing changes for an average of 15.2 days ± 2.7, whereas the second group averaged 9.7 days ± 3.2. Complications arose in 19 patients (52.8%) during the follow-up period.
Conclusions: through and through mattress suturing streamlined surgical duration, reduced postoperative complications, minimized dressing changes, and shortened hospitalize time. This ultimately cut costs, enhancing convenience for both healthcare providers and patients. Hence, through and through mattress suturing are preferred for graft fixation.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The authors retain the copyright and grant the right to publish in the magazine for the first time with the transfer of the commercial right to Tishreen University Journal for Research and Scientific Studies - Health Sciences Series
Under a CC BY- NC-SA 04 license that allows others to share the work with of the work's authorship and initial publication in this journal. Authors can use a copy of their articles in their scientific activity, and on their scientific websites, provided that the place of publication is indicted in Tishreen University Journal for Research and Scientific Studies - Health Sciences Series . The Readers have the right to send, print and subscribe to the initial version of the article, and the title of Tishreen University Journal for Research and Scientific Studies - Health Sciences Series Publisher
journal uses a CC BY-NC-SA license which mean
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
- The licensor cannot revoke these freedoms as long as you follow the license terms.
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes.
- ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.