Optimizing adherence of full-thickness skin grafts to the wound bed of the nasal ala with the 'sandwich suture'

摘要

Madam, Skin cancers on the nose are common.1 Following surgical excision of a lesion on the nasal ala, many reconstructive surgeons will utilize a full-thickness skin graft (FTSG), harvested from a number of potential donor sites, to repair such a defect. In order to maximize adherence of the graft to the wound bed, minimize movement and reduce shearing forces, the use of a tie-over bolster dressing is common practice when performing FTSGs.The 'nasal ala FTSG' is challenging for the reconstructive surgeon in that any form of external pressure, such as a bolster, collapses the nasal vestibule. Not only is this uncomfortable for the patient but also does not maximize the adherence of the undersurface of the graft to the wound bed.