Use of wire frame tie-over to fix the facial skin grafts
- VernacularTitle:金属框架打包植皮法在面部植皮中的应用
- Author:
Xin CHEN
;
Fengjun QIN
;
Hui CHEN
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;0(14):-
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Facial tie-over is a conventional method for skin graft fixation, but it needs further improvements due to the unsatisfactory fixation, survival quality, postoperational contraction and appearance. OBJECTIVE: To improve the survival quality of facial skin grafts using the modified wire frame tie-over for the fixation. DESIGN, TIME AND SETTING: An observation trial was carried out at the Department of Burns in Beijing Jishuitan Hospital from January 2003 to December 2007. PARTICIPANTS AND MATERIALS: A total of 23 patients suffered from facial burns and post-burn scar were enrolled from the Department of Burns in Beijing Jishuitan Hospital, 16 males and 7 females, with a mean age of (37?18) years. The wire frame tie-over skin grafts were used in 32 facial wounds, including 8 cheek wounds, 20 eyelid wounds and 4 perioral wounds. The 1.0-1.5 Kirschner wire frame, made of stainless steel, was shaped as the wound outline; the rubber bands and clip were sterilized with ethylene oxide. METHODS: All the patients were grafted by means of wire frame tie-over, and the maximal area of skin graft was 18 cm?10 cm. After the routine skin grafting, the Kirschner wire frame was sutured to the edge of wound, then tie-over was performed using the sutures or the sterilized rubber bands fixed on the wire frame. The wire frame was removed three to four weeks after operation. MAIN OUTCOME MEASURES: The survival of skin grafts was recorded at the removal of tie-over, including survival rate of skin grafts and appearance of crater phenomenon that was prominent at edges and depressed in center; The skin grafts were pictured to observe the early contraction at the removal of wire frames 3-4 weeks later. The patients who were potential for the long-term follow-ups were used to observe the long-term contraction. RESULTS: Among 32 wounds in 23 patients, 31 skin grafts had an excellent skin grafting, except a partial graft necrosis occurred in one case due to insufficient debridement. The skin grafts were flat and intact, no crater phenomenon was found. Three or four weeks after operation, the area of skin grafts maintained in original style, no early contraction was found. One year later, the patients appeared mild contraction of skin graft, and the skin appearance was satisfactory. CONCLUSION: Improved wire frame tie-over method can increase the survival quality of facial grafts and alleviate the graft contraction.
