title: Fixation of split-thickness skin graft using fast-clotting fibrin glue containing undiluted high-concentration thrombin or sutures: a comparison study.
abstract: OBJECTIVE
  For skin defects caused by full-thickness burns, trauma, or tumor tissue excision, skin grafting is one of the most convenient and useful treatment methods. In this situation, graft fixation is important in skin grafting. This study was performed to compare the effectiveness of skin graft fixation between high-concentration fibrin sealant and sutures. There have been numerous studies using fibrin sealant for graft fixation, but they utilized slow-clotting fibrin sealant containing less than 10 IU/mL thrombin.
  
  
  METHODS
  Twenty-five patients underwent split-thickness skin grafting using fast-clotting fibrin sealant containing 400 IU/mL thrombin, while 30 patients underwent grafting using sutures. Rates of hematoma/seroma formation, graft dislocation, graft necrosis, and graft take were investigated postoperatively. The graft surface area was calculated using Image J software (National Institutes of Health, Bethesda, MD, USA).
  
  
  RESULTS
  After 5 days, rates of hematoma/seroma formation and graft dislocation were 7.84 and 1.29% in group I, and 9.55 and 1.45% in group II, respectively. After 30 days, rates of graft necrosis and graft take were 1.86 and 98.14% in group I, and 4.65 and 95.35% in group II. Undiluted fibrin sealant showed significantly superior results for all rates (p< 0.05) except graft dislocation.
  
  
  CONCLUSIONS
  When high-concentration fast-clotting fibrin sealant was applied to skin grafts without dilution, no difficulty was experienced during surgery. Sealant showed superior results compared with sutures and had an excellent graft take rate.
  
  
  METHODS
  II.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hyun Ho
authors.initials: HH
authors.lastname: Han
authors.affiliation: Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Daiwon
authors.initials: D
authors.lastname: Jun
authors.affiliation: Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Suk-Ho
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Plastic and Reconstructive Surgery,St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: In Sook
authors.initials: IS
authors.lastname: Kang
authors.affiliation: Department of Plastic and Reconstructive Surgery,St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Kim
keywords: Fast clotting; Fibrin sealant; Split-thickness skin graft; Suture; Thrombin