A Multilayered Polyurethane Foam Technique for Skin Graft Immobilization

BACKGROUND Several techniques are applicable for skin graft immobilization. Although the sponge dressing is a popular technique, pressure failure near the center of the graft is a weakness of the technique that can result in engraftment failure. OBJECTIVE To evaluate the efficacy of a new skin graft immobilization technique using multilayered polyurethane foam in vivo and in vitro. METHODS AND MATERIALS Twenty-six patients underwent a full-thickness skin graft. Multiple layers of a hydrocellular polyurethane foam dressing were used for skin graft immobilization. In addition, we created an in vitro skin graft model that allowed us to estimate immobilization pressure at the center and edges of skin grafts of various sizes. RESULTS Overall mean graft survival was 88.9%. In the head and neck region ( 19 patients), mean graft survival was 93.6%. Based on the in vitro outcomes, this technique supplies effective pressure (< 30 mmHg) to the center region of the skin graft. CONCLUSIONS This multilayered polyurethane foam dressing is simple, safe, and effective for skin graft immobilization.