title: A tie-over dressing using a silicone tube to graft deep wounds.
abstract: BACKGROUND
  The most common cause of skin graft failure is the collection of blood or serous fluid underneath the graft. In our study, we describe the use of silicone tube for tie-over dressing to secure the skin graft margins with the aim of decreasing loss of the skin graft, particularly in grafting of deep wounds.
  
  
  METHODS
  Between March 2008 and July 2011, we used this technique in 17 patients with skin defects with depths ranging from 3.5 to 8 mm (mean, 5.5 mm). First, the skin graft was sutured with 3/0 silk suture material from its corners. Then, a silicone round drain tube was sutured with 3/0 absorbable polyglactin 910 over the margins of the graft. Finally, long silk threads were tied over the bolus dressing, and the tie-over dressing was completed in the usual fashion.
  
  
  RESULTS
  The mean follow-up was 7 months (range, 2-10 months) in the outpatient clinic. Graft loss on the graft margins due to hematoma or seroma was not developed. The results of adhesion between the graft and wound bed peripherally was excellent.
  
  
  CONCLUSIONS
  In our study, we suggest that use of a silicone tube for additional pressure on the edges of skin grafts in case of reconstruction of deep skin defects.
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Clinic, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Cem Inan
authors.initials: CI
authors.lastname: Bektas
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Kankaya
authors.forename: Kadri
authors.initials: K
authors.lastname: Ozer
authors.forename: Ruser
authors.initials: R
authors.lastname: Baris
authors.forename: Ozlem Colak
authors.initials: OC
authors.lastname: Aslan
authors.forename: Ugur
authors.initials: U
authors.lastname: Kocer
keywords: Occlusive dressings; Silicones; Skin transplantation