Experience with elastic rubber bands for the tie-over dressing in skin graft.

We derived a dressing using elastic rubber bands to tie over the skin graft. This is a simple, easy to perform, timesaving, inexpensive and reliable method for applying pressure over the skin graft compared with traditional methods. Between September 2002 and August 2004, we have used the present dressing technique in 35 patients with 36 grafts in various parts of the body. We chose this method, because of some anatomic areas, such as back, and buttock, which are frequently quite difficult to maintain pressure dressings in place, minimal movement can cause the skin graft to dislodge. The elastic rubber bands, rather than threads, are used as tie-over. Such a dressing permits expansion and contraction, providing a dynamic quality in the most difficult anatomic locations. The patient group consisted of 23 males and 12 females. The age ranged from 34 to 82 years (mean 52.4 years). Defect size ranged from 3x2.5 to 30x20 cm2 (mean 11.2x7.0 cm2 in size). The average follow-up was 5.8 months (range: 1-12 months). Among the 36 grafts in our study, all grafts except four showed good to excellent results. The mean graft successful rate is 88%. With our procedure no hematoma formation or shearing force (except one case) occurred in this group of patients during the phase of revascularization, there was, hence, good fixation of the graft by the "tie-over" dressing using elastic rubber bands compared with conventional tie-over dressing, especially in skin grafts of the back site of body and at large graft area. However, it is not suitable for the potentially infectious granulation beds, especially near joint area.