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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(01): 060-066
DOI: 10.1055/s-0043-1777867
Original Article

An Outcome Analysis of Fibrin Sealant versus Staples for Fixation of Split-Thickness Skin Grafts

Akshara Shuchi
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
,
Deepti Gupta 
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
,
Sujata Sarabahi
1   Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
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Abstract

Background Skin grafting plays a vital role in post-burn and post-traumatic wound management. Split-thickness skin grafts (STSG) are traditionally fixed using staples or sutures, which have tedious application and their removal necessitates painkillers, medical equipment, and human intervention. As an alternative, fibrin sealant is a biological tissue adhesive, composed of thrombin, calcium, and fibrinogen. Fibrin sealant promotes hemostasis and acts as a biological adherent.

Objective The aim of this study was to evaluate the outcomes (graft take, wound healing and complications) of fibrin sealant and staples for STSG fixation.

Methods It is a randomized controlled trial on 40 patients with wounds of minimum 400 cm2. Wound area was divided into equal halves and randomly allocated to the study group or control group. In the study group, 4 mL per 200 cm2 of fibrin sealant was sprayed followed by STSG application. In the control group, STSG was fixed with only skin staples. Evaluation was done on postoperative days 3, 5, 15, and 30 for graft take, hematoma/seroma, infection, and complete wound healing.

Results The mean graft take was significantly higher (p-value < 0.05) in the study group than in the control group (91 vs. 89%). No seroma or hematoma formation was seen in either group. Complete wound healing was seen in more patients in the study group, but the difference was statistically insignificant.

Conclusion Fibrin sealant is an excellent alternative to staples for skin grafting, with the advantage of better graft take and being free of pain that is incurred during staple removal.

Keywords

fibrin sealant - split-thickness skin grafting - granulating raw area - staples

Clinical Trial Registration Information

Clinical Trials Registry - India (CTRI): www.ctri.nic.in/


Registration No CTRI/2022/08/044992


Institutional Review Board Certificate

The Institutional Review Board/Thesis Protocol Review Committee of VMMC and Safdarjung Hospital, New Delhi, has reviewed and approved the study to be conducted in the present form at VMMC and Safdarjung hospital, New Delhi.




Publication History

Article published online:
05 January 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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