A Sutureless Full-Thickness Skin Graft with a Silicon Layer (Mepitel® One)

Abstract

Background: One of the cosmetic problems after a skin graft operation is the scar caused by sutures. This report describes a method of graft fixation without sutures that allows for an improved aesthetic appearance.
Methods: Mepitel® One (Mölnlycke®, Tokyo, Japan) multiparous silicon sheet is a self-adhesive transparent sheet was cut out slightly wider than the area of the skin defect and applied to the area for skin harvesting. The graft with Mepitel® One was harvested and transplanted to the defect and this graft was secured with another Mepitel® One. After one to two weeks, all Mepitel® One was removed, and an ointment containing antibiotics was applied.
Results: Twenty-three patients (8 men and 15 women) underwent this procedure. The maximum size of the skin graft fragments was 55 mm × 70 mm. In three cases, infection led to partial necrosis, but resulted in epithelialization without scarring contracture. The other cases healed completely.
Conclusions: This method has many advantages: (1) Using Mepitel® One as a template for skin retrieval, Mepitel® One will not tear even if it is contaminated with water or blood. (2) In Mepitel® One, it is easy to distinguish the polyurethane film side from the adhesive side, so there is no chance of mistaking the front and back when using it as a template. (3) Because Mepitel® One remains attached to the skin even after harvesting, it prevents the graft from curling up and eliminates the need to redeploy the graft at the wound bed. This makes it possible to transplant without suturing the skin graft, eliminates the need for local anesthetic injections, and shortens the operation time.