Full-Thickness Skin Grafts for Lower Leg Defects

Audrain, H.; Bray, Adam; Berker, David de

doi:10.1097/dss.0000000000000330

Cited by 25 publications

(27 citation statements)

References 19 publications

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“…Fifteen articles met the inclusion criteria involving only skin surgery (for details see Table S1, Supplemental Digital Content 4, http://links.lww.com/DSS/A423. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Three studies used randomization, [28][29][30] and 4 studies compared a no tie-over dressing with a tie-over dressing but did not always specify the materials used for the bolster. 27,29,31,33 Two articles mentioned both STSGs and FTSGs and did not subdivide the graft take per technique.…”

Section: Search Resultsmentioning

confidence: 99%

“…28,38 Thirteen studies used only FTSGs. [25][26][27][29][30][31][32][33][34][35][36][37]39 The graft defect size was described in different measurements of length (mm and cm) or surface area (mm 2 and cm 2 ) and varied from 8 mm in length (smallest) 34 to 52.4 cm 2 (largest area). 25 Nine studies reported the use of additional antibiotics: systemic 35 and local.…”

Section: Search Resultsmentioning

confidence: 99%

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To Tie or Not to Tie-Over Full-Thickness Skin Grafts in Dermatologic Surgery: A Systematic Review of the Literature

et al. 2020

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BACKGROUND Tie-over dressings are frequently used for skin grafts. Although a dressing is necessary for split-thickness skin grafts, their use in full-thickness skin grafts (FTSGs) is questionable. OBJECTIVE This review was conducted to investigate the influence of different tie overs and dressings on graft take for FTSGs in cutaneous surgery. MATERIALS AND METHODS An electronic database search was performed in MEDLINE, EMBASE, Web of Science, and the Cochrane library. The following search terms and comparable were used: skin transplantation, tie-over, fixation, sutures, and take. RESULTS Fifteen articles met the inclusion criteria. Eight studies describe no use of a tie-over dressing for FTSGs. Dressing types included antibacterial dressings, foam or sponges, and bolsters. The lowest graft take was 80% (with a tieover dressing). The highest graft take was 100% (with and without a tie-over dressing). CONCLUSION The results show that, regardless of the technique used, the overall graft success rate is high. Although a definite recommendation could not be made, it seems that a graft without a tie-over dressing can suffice in certain circumstances.

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Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

To Tie or Not to Tie-Over Full-Thickness Skin Grafts in Dermatologic Surgery: A Systematic Review of the Literature

et al. 2020

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“…Flap and graft reconstruction are the types of surgeries associated with the highest risk for SSI . Graft take in lower leg surgeries have been reported at rates of 64% to 90%, depending on the study . The risk of bleeding complications has previously been reported to be between 0.3% and 3% and for necrosis between 1.7% and 8.6% …”

Section: Discussionmentioning

confidence: 99%

“…1,18 Graft take in lower leg surgeries have been reported at rates of 64% to 90%, depending on the study. 13,22,23 The risk of bleeding complications has previously been reported to be between 0.3% and 3% 1,5,16 and for necrosis between 1.7% and 8.6%. 1,5 Honaker et al 6 evaluated the complication risk of 69 patients in below-knee Mohs surgery, with an overall complication rate of 17%, of which 50% were infections, 3.25% delayed wound healing, 2.17% hypergranulation, and 8% hypertrophic scars.…”

Section: Discussionmentioning

confidence: 99%

Evaluating complications in below‐knee skin cancer surgery after introduction of preoperative appointments: A 2‐year retrospective cohort study

Lindholm

Isoherranen

Schröder

et al. 2019

International Wound Journal

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Below‐knee dermatological surgery has a high risk of complications such as wound infection, bleeding, and necrosis. In this study, we evaluated the impact of preoperative appointments on complication risks. We searched the medical records of the Helsinki University Central Hospital (HUS) Dermatosurgery unit for all below‐knee surgeries during 2016, when no preoperative nurse appointments were carried out, and compared it with 2018, when preoperative appointments for risk patients were introduced. The study included 187 patients in 2016 and 179 patients in 2018, of whom 68 (about one third) attended preoperative appointments. At the appointments, risk factors were evaluated, and compression therapy was introduced when possible. The results show complication rates of 13.4% in 2016 vs 10.1% in 2018 (P = .33), despite significantly higher risks in the 2018 patient group. The odds ratio for complications in appointment attendees vs non‐attendees was reduced after adjustments to 0.58; however, this was insignificant (P = .47). The odds of complications for skin grafts were considerably higher: 11.33 vs other surgery techniques (P = .00). In conclusion, the introduction of preoperative appointments appeared to reduce complications in below‐knee surgery. For graft reconstructions, complication risk is high, even with carefully planned pre‐ and postoperative care. Further studies are needed to evaluate preventable risk factors of below‐knee graft reconstructions.

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“…Surgical excisions on the leg pose a series of challenges. The elliptical excision is generally considered the option of choice when possible, with advantages of simple design, widespread application on most parts of the leg and ease of specimen orientation if further excision is required . However, an elliptical excision may result in excessive tissue tension and an inability to close the defect.…”

Section: Introductionmentioning

confidence: 99%

‘Tramline Rescue’: A salvage technique for the failed elliptical excision on the leg

Coe

Lyon

2019

Aust J Dermatology

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Full-Thickness Skin Grafts for Lower Leg Defects

Abstract: Full-thickness skin graft is an effective method of repairing defects on the lower leg after removal of cutaneous lesions. The aftercare of FTSG was acceptable with 86% of patients requiring 5 or fewer visits to secondary care.

Cited by 25 publications

References 19 publications

To Tie or Not to Tie-Over Full-Thickness Skin Grafts in Dermatologic Surgery: A Systematic Review of the Literature

To Tie or Not to Tie-Over Full-Thickness Skin Grafts in Dermatologic Surgery: A Systematic Review of the Literature

Evaluating complications in below‐knee skin cancer surgery after introduction of preoperative appointments: A 2‐year retrospective cohort study

‘Tramline Rescue’: A salvage technique for the failed elliptical excision on the leg

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