title: External wire-frame fixation of digital skin grafts: a non-invasive alternative to the K-wire insertion method.
abstract: OBJECTIVE
  The current skin graft fixation methods for digits, including the Kirschner wire insertion technique, can be limited by inadequate or excessive fixation and complications such as infection or secondary injuries. Therefore, the external wire-frame fixation method was invented and used for skin grafting of digits. This study aimed to investigate external wire-frame fixation of digital skin grafts as a non-invasive alternative to the K-wire insertion method.
  
  
  METHODS
  In 2005-2012, 15 patients with burn scar contractures on the hand digits received a skin graft that was then fixed with an external wire frame. The intra-operative time needed to make the wire frame, the postoperative time to frame and suture removal, the graft survival rate, the effect of contracture release and the complications were recorded.
  
  
  RESULTS
  In all cases, the contracture release was 100%. The complete graft survival rate was 98.6%. Four patients had epithelial necrosis in <5% of the total area. There were no other complications such as pressure ulcer or hypoxia of fingers.
  
  
  CONCLUSIONS
  External wire-frame fixation is simple, minimally invasive and a custom-made technique for skin grafting of the fingers. It was designed for its potential benefits and the decreased risk it poses to patients with scar contractures on their fingers. It can be implemented in three phases of grafting, does not affect the epiphyseal line or subsequent finger growth and is suitable for children with multi-digit involvement.
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan; Department of Plastic Surgery, Meitan General Hospital, Beijing, China.
authors: Chenyu
authors: C
authors: Huang
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan. Electronic address: r.ogawa@nms.ac.jp.
authors: Rei
authors: R
authors: Ogawa
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.
authors: Hiko
authors: H
authors: Hyakusoku
mesh_terms: D000293:Adolescent; D000368:Aged; D001864:Bone Wires; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D016038:Skin Transplantation / Q000295:instrumentation / Q000379:methods*
keywords: Digital skin graft; External wire frame fixation; Hand; K-wire; K-wire insertion; Kirshner wire; Skin graft