title: Tie-over bolster dressings may not be necessary to secure small full thickness skin grafts.
abstract: BACKGROUND
  The accepted method for securing full thickness skin grafts (FTSG) is with a tie-over bolster dressing, with or without basting sutures. We question the need for tie-over bolster dressings for small FTSGs.
  
  
  OBJECTIVE
  We describe our method of FTSG reconstruction and the outcome in a consecutive series.
  
  
  METHODS
  Thirty patients with surgical defects following tumour excision from the face24, scalp1, ear2, and finger3 ranging in diameter from 8 to 45 mm (mean 20 mm) were reconstructed with a FTSG. Interrupted monofilament nylon perimeter sutures only were used, with antibiotic ointment at the wound edge with either a light dressing or no dressing.
  
  
  RESULTS
  A series of 30 FTSG secured without a tie-over bolster dressing or basting sutures is described, all with good to excellent long term results. In two cases there was early superficial necrosis of the graft, but ultimately 100% graft take.
  
  
  CONCLUSIONS
  We have found tie-over bolster dressings and basting sutures to be unnecessary in our series of small FTSG. This technique saves time and material and minimizes handling of the graft.
authors.affiliation: Department of Dermatology, Sunderland Royal Hospital, United Kingdom.
authors.forename: J A
authors.initials: JA
authors.lastname: Langtry
authors.forename: P
authors.initials: P
authors.lastname: Kirkham
authors.forename: I C
authors.initials: IC
authors.lastname: Martin
authors.forename: A
authors.initials: A
authors.lastname: Fordyce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004428:Ear Neoplasms / Q000601:surgery; D004431:Ear, External / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery; D005260:Female; D005385:Fingers / Q000601:surgery; D006801:Humans; D007636:Keratoacanthoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012535:Scalp / Q000601:surgery; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D013536:Suture Techniques