529 Safeguarding Skin Grafts: A 21st Century Algorithm for Fixation Techniques

Abstract Aim Effective skin graft fixation is fundamental in preventing sheering forces, seroma and haematoma from compromising take. However, determining the ideal method of remains a contentious subject. Currently, there significant variation techniques used, based not only on clinical requirement, but also surgeon preference. Evidence-based recommendations are necessary to guide decision-making process. Method We undertook PRISMA-based assessment literature define all analyse their outcomes. Inclusion exclusion criteria were composed. A search Medline Embase was performed, yielding 399 articles. After abstract screening, 96 included for qualitative data analysis. Results Nine identified: ‘tie over bolster’, ‘staple fixation’, ‘simple dressings’, ‘quilting sutures’, ‘re-look methods’, ‘foam sponge ‘adhesive glues’, ‘negative pressure wound therapy’ ‘less common techniques. available evidence each technique, identifying 13 studies with level I/II evidence. summarise research that underpins these nine categories, proposing an algorithm facilitate technique selection anatomical patient-specific factors. Conclusions An array used plastic surgery, without clear guidelines. To our knowledge, this first time have been defined. Our suggested intended aid surgeons selecting appropriate should be challenged by future research, particularly randomised control trials.