Mefix as a painless alternative to staples in securing foam to skin graft recipient sites
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10. Al-Qattan MM, Hashem FK, Al Malaq A. An unusual case of preaxial polydactyly of the hands and feet: a case report. J Hand Surg [Am] 2002;27:498e502. 11. Yildirim S, Taylan G, Aydogdu E, et al. The true triplication of the thumb: a case of unclassified thumb polydactyly. Ann Plast Surg 2005;55:321e3. 12. Marangoz S, Leblebicioglu G. Thumb polydactyly with radius hypoplasia: a case report. J Hand Surg [Am] 2006; 31:1667e70. 13. TemTamy SA, McKusick VA. The Genetics of Hand Malforma- tions (Birth Defects Original Article Series). vol. 14. New York: A.R. Liss; 1978. p. 1e619. 14. Hovius SE, Zuidam JM, Wit de T. Treatment of the triphalangeal thumb. Tech Hand Up Extrem Surg 2004;8:247e56. 15. Elliott AM, Evans JA, Chudley AE, et al. The duplicated longitu- dinal epiphysis or ‘‘kissing delta phalanx’’: evolution and vari- ation in three different disorders. Skeletal Radiol 2004;33: 345e51. 16. Buck-Gramcko D, Behrens P. Classification of polydactyly of the hand and foot. Handchir Mikrochir Plast Chir 1989;21:195e204 [in German]. 17. Blauth W, Olason AT. Classification of polydactyly of the hands and feet. Arch Orthop Trauma Surg 1988;107:334e44. 18. Upton J, Shoen S. In: Gupta A, Kay SPJ, Scheker LR, editors. Triphalangeal Thumb, in the Growing Hand: Diagnosis and Management of the Upper Extremity in Children. London: Mosby; 2000. p. 255e68. 19. Kozin SH. Deformities of the thumb. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe SW, editors. Green’s Oper- ative Hand Surgery . Philadelphia: Elsevier, Churchill Living- stone; 2005. p. 1445e68. 20. Zuidam JM, Dees EE, Lequin MH, et al. The effect of the epiph- yseal growth late on the length of the first metacarpal in triphalangeal thumb. J Hand Surg [Am] 2006;31:1183e8. 21. Peimer CA. Combined reduction osteotomy for triphalangeal thumb. J Hand Surg [Am] 1985;10:376e81. CLINICAL TIP Mefix as a painless alternative to staples in securing foam to skin graft recipient sites Several different methods have been used to immobilise skin grafts on their underlying recipient bed. The use of sponge and staples 1 is a fast and easy technique from a surgical perspective, but patients often find the removal of staples extremely painful. Mefix is a cheap, adhesive dressing that has proven successful on skin graft donor sites. 2 The memory of the material can be overcome either by removing both strips of the backing material simultaneously or by crumpling it 3 and it can be subsequently released from the skin with the application of alcohol gel which helps to remove the adhesive. 4 Mefix (£ 0.26 / metre) is also less expen- sive than staples (£ 5.00 per stapler). We have been using mefix as an alternative to staples in foam tie over dressings and this has proven beneficial in avoiding the pain associated with staple removal. Mepitel was used as the primary dressing in contact with the skin graft itself, then foam, a single layer of gauze and finally mefix to secure these layers to the surrounding skin. The dressing is not suitable for all anatomical sites, but is particularly useful on the lower limbs. References 1. Kaplan HY. A quick stapler tie-over fixation for skin grafts. Ann Plast Surg 1989;22:173e4. 2. Hormbrey E, Pandya A, Giele H. Adhesive retention dressings are more comfortable than alginate dressings on split-skin- graft donor sites. Br J Plast Surg 2003;56:498e503. 3. Pinder RM, Morrison CM, Knight SL. Preventing the self- adherence of Mefix. J Plast Reconstr Aesthet Surg 2007;60:960. 4. Burge TS. Removing adhesive retention dressings. Br J Plast Surg 2004;57:93. Thomas Macleod K. Steele Leicester Royal Infirmary, Department of Plastic Surgery, Infirmary Square, Leicester LE1 5WW, United Kingdom E-mail address: [email protected] ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2007.12.051 1084 J.M. Zuidam et al.
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Transcript of Mefix as a painless alternative to staples in securing foam to skin graft recipient sites
1084 J.M. Zuidam et al.
10. Al-Qattan MM, Hashem FK, Al Malaq A. An unusual case ofpreaxial polydactyly of the hands and feet: a case report.J Hand Surg [Am] 2002;27:498e502.
11. Yildirim S, Taylan G, Aydogdu E, et al. The true triplication ofthe thumb: a case of unclassified thumb polydactyly. Ann PlastSurg 2005;55:321e3.
12. Marangoz S, Leblebicioglu G. Thumb polydactyly withradius hypoplasia: a case report. J Hand Surg [Am] 2006;31:1667e70.
13. TemTamy SA, McKusick VA. The Genetics of Hand Malforma-tions (Birth Defects Original Article Series). vol. 14. NewYork: A.R. Liss; 1978. p. 1e619.
14. Hovius SE, Zuidam JM, Wit de T. Treatment of the triphalangealthumb. Tech Hand Up Extrem Surg 2004;8:247e56.
15. Elliott AM, Evans JA, Chudley AE, et al. The duplicated longitu-dinal epiphysis or ‘‘kissing delta phalanx’’: evolution and vari-ation in three different disorders. Skeletal Radiol 2004;33:345e51.
16. Buck-Gramcko D, Behrens P. Classification of polydactyly of thehand and foot. Handchir Mikrochir Plast Chir 1989;21:195e204[in German].
17. Blauth W, Olason AT. Classification of polydactyly of the handsand feet. Arch Orthop Trauma Surg 1988;107:334e44.
18. Upton J, Shoen S. In: Gupta A, Kay SPJ, Scheker LR, editors.Triphalangeal Thumb, in the Growing Hand: Diagnosis andManagement of the Upper Extremity in Children. London:Mosby; 2000. p. 255e68.
19. Kozin SH. Deformities of the thumb. In: Green DP,Hotchkiss RN, Pederson WC, Wolfe SW, editors. Green’s Oper-ative Hand Surgery. Philadelphia: Elsevier, Churchill Living-stone; 2005. p. 1445e68.
20. Zuidam JM, Dees EE, Lequin MH, et al. The effect of the epiph-yseal growth late on the length of the first metacarpal intriphalangeal thumb. J Hand Surg [Am] 2006;31:1183e8.
21. Peimer CA. Combined reduction osteotomy for triphalangealthumb. J Hand Surg [Am] 1985;10:376e81.
CLINICAL TIP
Mefix as a painless alternative to staples in securingfoam to skin graft recipient sites
Several different methods have been used to immobiliseskin grafts on their underlying recipient bed. The use ofsponge and staples1 is a fast and easy technique froma surgical perspective, but patients often find theremoval of staples extremely painful.
Mefix is a cheap, adhesive dressing that has provensuccessful on skin graft donor sites.2 The memory of thematerial can be overcome either by removing both stripsof the backing material simultaneously or by crumplingit3 and it can be subsequently released from the skinwith the application of alcohol gel which helps to removethe adhesive.4 Mefix (£ 0.26 / metre) is also less expen-sive than staples (£ 5.00 per stapler).
We have been using mefix as an alternative to staples infoam tie over dressings and this has proven beneficial inavoiding the pain associated with staple removal. Mepitelwas used as the primary dressing in contact with the skingraft itself, then foam, a single layer of gauze and finallymefix to secure these layers to the surrounding skin. Thedressing is not suitable for all anatomical sites, but isparticularly useful on the lower limbs.
References
1. Kaplan HY. A quick stapler tie-over fixation for skin grafts.Ann Plast Surg 1989;22:173e4.
2. Hormbrey E, Pandya A, Giele H. Adhesive retention dressingsare more comfortable than alginate dressings on split-skin-graft donor sites. Br J Plast Surg 2003;56:498e503.
3. Pinder RM, Morrison CM, Knight SL. Preventing the self-adherence of Mefix. J Plast Reconstr Aesthet Surg 2007;60:960.
4. Burge TS. Removing adhesive retention dressings. Br J PlastSurg 2004;57:93.
Thomas MacleodK. Steele
Leicester Royal Infirmary,Department of Plastic Surgery, Infirmary Square,
Leicester LE1 5WW,United Kingdom
E-mail address: [email protected]
ª 2008 British Association of Plastic, Reconstructive andAesthetic Surgeons. Published by Elsevier Ltd. All rightsreserved.
doi:10.1016/j.bjps.2007.12.051
