開口部が狭い広範な胸腔皮膚瘻に対するインレー植皮における新しい分層植皮片固定法

抄録

 Various surgical methods have been considered for fixation after split-thickness skin grafting, depending on the size and location of the skin defect. We performed split-thickness skin grafting in the lumen of a thoracic cutaneous fistula. Considering the potential difficulty in fixing the inlay skin graft, we devised a novel surgical procedure using a tissue expander (TE) and obtained good results.
 Our patient was a 67-year-old man who developed a thoracic cutaneous fistula with repeated infections originating from a bronchial segment following respiratory surgery for malignant pleural mesothelioma. When performing surgery for a fistula with a narrow skin opening and a wide sinus-like lumen, applying the skin graft to an appropriate position on the wall so that it effectively adheres and maintains postoperative pressure fixation is difficult. The TE technique allows for efficient skin graft adherence to the wall by injecting distilled water from the port and adjusting to attain appropriate fixation pressure.