Comparison of Full Thickness Autograft Fixation Methods in Facial Reconstructive Surgery

Abstract

Aim: Compare full thickness autograft fixation methods in facial reconstructive surgery patients. Methods:The study involved patients operated with similar-sized tumors of the face area. Patients were randomly divided into two groups. All patients received the same surgical technique, operated by the same surgeon, surgical wound depth – to the fascia, and the skin defect was covered with a full thickness skin autograft. After the operation, for the first group autograft was covered with polyurethane dressing contained on the base a silicone membrane, additionaly fixing with single stitchers, for the second group – paraffin dressing and gauze pad, fixing with adhesive tape. After 7 days postop an assesment was made: autograft engraftment in percentages and dressing position. Results: Study involved 18 patients, 7 men and 11 women with a mean age of 66±7 years. The first group – 10 patients, surgical wound area 2.1±0.7 cm². The second group – 8 patients, wound area 1.6±0.4 cm². No difference in wound area estimation (p = 0.001). In the first group, all grafts completely healed and dressings had no dislocation, being firmly fixed with single stitchers. In the second group, 5 grafts completely healed, 2 – partial engraftment, one graft falled. For two patients dressings were partially displaced, what probably influenced partial skin engraftment. Conclusions: Full thickness autograft fixation with polyurethane dressing additionaly fixing with single stitchers is more efficient for skin engraftment in the face area. Due to mimic facial muscle movements it is difficult to maintain good graft immobilization, therefore we recommend to use more technically sophisticated, but effective fixing method.