Skin Graft Fixation Using Hydrofiber (Aquacel® Extra)

Yen, Ya-Hui; Lin, Chih‐Ming; Hsu, Honda; Chen, Ying‐Chen; Chen, Yiwen; Li, Wanyu; Hsieh, Chia-Nan; Huang, Chieh-Chi

doi:10.1097/sap.0000000000001432

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…Longer operative time is one of the technical disadvantages of the conventional tie-over bolster technique due to the additional materials and application steps involved [4]. Akihiko et al suggested the use of a polyurethane foam and elastic tapes to shorten the operative time, reduce medical waste, and produce likely graft outcomes, instead of using the conventional continuous sutures and knots on bolsters [25].…”

Section: Discussionmentioning

confidence: 99%

“…However, this technique has some disadvantages for both patients and clinicians. Patients may experience postoperative pain due to the tension of the bolster sutures and tearing pain during the removal of the tie-over dressing [4]. Postoperative pain is highly related to the tension caused by the silk or nylon sutures used in the tie-over bolster technique, and tearing pain is mainly due to the adhesion of the inner layer of the petrolatum gauze to the tissues [5].…”

Section: Introductionmentioning

confidence: 99%

“…Splints are used when the tie-over method is applied to the extremities. However, the heavy and uncomfortable feeling caused by these structures must be taken into consideration during postoperative wound care; furthermore, the splints may add to unnecessary medical waste [4]. For clinicians, placing sutures around the periphery to affix the graft to the wound bed is a time-consuming and challenging procedure [6].…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Study on the Clinical Superiority of the Vacuum-Assisted Closure System with a Silicon-Based Dressing over the Conventional Tie-over Bolster Technique in Skin Graft Fixation

Chou

Hsieh

et al. 2019

Medicina

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Background and Objectives: The tie-over bolster technique has been conventionally used for skin graft fixation; however, long operative times and postoperative pain are the main disadvantages of this method. In this study, we introduce a new method using vacuum-assisted closure (VAC) with a silicon-based dressing as an alternative for skin graft fixation. This retrospective study aimed to evaluate the clinical effect of the VAC plus silicon-based dressing method and the conventional tie-over bolster technique for skin graft fixation in terms of pain, operative time, and skin graft take rate. Materials and Methods: Sixty patients who underwent skin graft surgery performed by a single surgeon from January 2017 to October 2018 were included in this clinical study. They were divided into two groups based on the type of treatment: tie-over bolster technique and vacuum-assisted closure (VAC), or silicon-based dressing groups. The operative times were recorded twice (during suturing or stapling of the graft and during removal of the dressing) in the two groups; similarly, pain was assessed using a numeric rating scale (NRS) after surgery and during dressing removal. Skin graft take rate was evaluated two weeks after dressing removal. Results: Twenty-six patients who met the eligibility criteria were enrolled into the study and assigned to one of the two groups (n = 13 each). No significant differences in age, gender, and graft area were noted between the two groups of patients. The VAC plus silicon-based dressing group demonstrated higher skin graft take rates (p < 0.05), shorter operation times (p < 0.05), and lower levels of pain (postoperative pain and pain during dressing removal) compared with the tie-over bolster technique group (p < 0.05). Conclusions: These findings indicate that VAC with silicon-based dressing can be used for skin graft fixation due to its superior properties when compared with the conventional method, and can improve the quality of life of patients undergoing skin graft fixation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retrospective Study on the Clinical Superiority of the Vacuum-Assisted Closure System with a Silicon-Based Dressing over the Conventional Tie-over Bolster Technique in Skin Graft Fixation

Chou

Hsieh

et al. 2019

Medicina

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“…A systematic review aimed to determine the effects of different methods on venous leg ulcer debridement reported hydrofiber dressings are less superior than biocellulose in a total mean reduction in ulcer size (Gethin et al, 2015). The results of a retrospective study showed that the use of hydrofiber Aquacel Extra for skin graft fixation was effective and technically very simple to use in the clinical setting (Yen et al, 2018). More complex dressing, such as silver containing hydrofiber dressing Aquacel Ag, has been reported to promote healing of partial thickness burns in pediatric patients (Lau et al, 2016).…”

Section: Evidence Of Effectivenessmentioning

confidence: 99%

First-Line Interactive Wound Dressing Update: A Comprehensive Review of the Evidence

2020

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Wound management is a significant and growing issue worldwide. Knowledge of dressing products and clinical expertise in dressing selection are two major components in holistic wound management to ensure evidence-based wound care. With expanding global market of dressing products, there is need to update clinician knowledge of dressing properties in wound care. Optimal wound management depends on accurate patient assessment, wound diagnosis, clinicians' knowledge of the wound healing process and properties of wound dressings. We conducted a comprehensive review of the physical properties of wound dressing products, including the advantages and disadvantages, indications and contraindications and effectiveness of first-line interactive/bioactive dressing groups commonly used in clinical practice. These include semipermeable films, foams, hydroactives, alginates, hydrofibers, hydrocolloids, and hydrogels. In making decisions regarding dressing product selection, clinicians need to ensure a holistic assessment of patient and wound etiology, and understand dressing properties when making clinical decisions using wound management guidelines to ensure optimal patient outcomes. This review has highlighted there is lack of high quality evidence and the need for future well designed trials.

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“… 1 Numerous methods for fixation with tie-over bolster, negative pressure, tissue glue, and others are found in the literature because immobilization is essential to prevent graft loss. 3 However, there is a high rate of graft loss that is still unreported.…”

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confidence: 99%