• Chinmaya Chiranjibi Samal, Suvashis Dash, Karoon Agrawal, and Raman Tandon.
• Dept. of Plastic Surgery, Hi-Tech Medical College, Bhubaneswar, Odisha 751025, India. Electronic address: dr.chinmay82@gmail.com.
• Burns. 2019 May 1; 45 (3): 691-698.

ObjectivesSplit thickness skin graft is an essential component of release of post burn contracture of neck. There are many methods of fixation of skin grafts; however, there is lack of objective comparison between different techniques. This study has been designed to compare three commonly used techniques of split thickness skin graft fixation methods. Surgical time, advantages, cost factor and post-operative outcome have been compared amongst three techniques.MethodsA randomized interventional comparative study was conducted to compare three methods of skin graft fixation in patients of 10-50 years age group, with contracture of more than 3 month duration having more than 100cm2 skin defects after contracture release. Resurfacing of the defects after contracture release was carried out in all the groups using autologous split skin grafts. Patients were included in three groups; Group 1: tie over method, Group 2: skin stapler fixation and Group 3: Cyanoacrylate glue fixation.ResultsMean duration of fixation procedure was 34min in tie over group, in skin stapler group 7min and in cyanoacrylate group 12min. Mean cost of fixation material was 10.23 USD in tie-over group, 11.23 USD in stapler group and 40.06 USD in cyanoacrylate group. Mean score of pain/discomfort (visual analog score) on dressing removal in tie-over group was 3, for skin stapler group was 2.9 and that for cyanoacrylate glue group was 1.8. mean graft take was found to be 90.1% in tie-over group, 94.1% in skin stapler group & 93.8% in cyanoacrylate glue group. On logistic regression analysis, keeping all the variables constant in the groups the complications as the outcome variable, three groups are comparable. The need for regrafting remains inconclusive.ConclusionsSkin stapler method for skin graft fixation was least time consuming, affordable and highly reliable when graft take success was considered. Cyanoacrylate glue fixation method was least painful and reliable in terms of graft take success though costlier than other two.Copyright © 2018. Published by Elsevier Ltd.

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