title: Use of a barbed suture tie-over technique for skin graft dressings: a case series.
abstract: BACKGROUND
  A tie-over dressing is the accepted method to secure skin grafts in order to prevent haematoma or seroma formation. We describe the novel application of a barbed suture tie-over for skin graft dressing. The barbs act as anchors in the skin so constant tensioning of the suture is not required.
  
  
  METHODS
  From January 2014 to August 2014 we used the technique in 30 patients with skin defects requiring split-thickness or full-thickness grafts. Patient demographics, clinicopathological details and graft outcome were collected prospectively.
  
  
  RESULTS
  The majority of cases were carried out for split-thickness skin grafts (n=19) used on the lower limb (n=20). The results of this novel technique were excellent with complete (100%) graft take in all patients.
  
  
  CONCLUSIONS
  Our results demonstrate the clinical application of a barbed device for securing skin grafts with excellent results. We find the technique quick to perform and the barbed device easy to handle, which can be applied without the need for an assistant.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Joyce
authors.affiliation: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors.forename: Cormac W
authors.initials: CW
authors.lastname: Joyce
authors.affiliation: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Mahon
authors.affiliation: Department of Plastic and Reconstructive Surgery, Galway University Hospital, Galway, Ireland. ; Department of Surgery, National University of Ireland, Galway, Ireland.
authors.forename: Jack L
authors.initials: JL
authors.lastname: Kelly
keywords: Graft survival; Occlusive dressings; Skin transplantation