Through-and-Through Mattress Suturing Versus Tie-Over Dressing in Full-Thickness Skin Graft Reconstruction.

Objective To compare the outcomes of securing full-thickness skin grafting (FTSG) with through-and-through mattress suturing versus the classic tie-over and pressure dressing and identify the associated risk factors of graft failure. Methods A single-institution, retrospective case series of patients who had undergone excision of head and neck skin lesions requiring FTSG over a 10-year period was reviewed. Results In total, 128 FTSG reconstructions were performed. The follow-up period ranged from 1 to 192 weeks. The observed graft take rate was 86.4%. There was no significant difference in the outcome when the surgical fixation technique was compared. Age, sex, or defect area did not affect the graft take rate. Smoking and the use of anticoagulants were not found to be contributory factors to graft failure. Conclusion Simple through-and-through mattress suturing provides adequate graft take, while minimizing tissue handling of the graft and reducing surgical time in comparison to the traditional tie-over and pressure technique.