The use of Steri-strips™ and quilting sutures for periocular full-thickness skin grafts: Avoiding a Frost suture or bolster

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PURPOSE: To assess the early complications and functional and esthetic outcomes of using quilting sutures and Steri-strips for full-thickness skin grafts (FTSGs) in the periocular region. METHODS: A retrospective, noncomparative, single-center review of patients who underwent FTSG with quilting sutures and Steri-strips splinting. Functional outcomes were assessed using MRD1 (margin reflex distance) and lagophthalmos on gentle closure for upper eyelid grafts, and MRD2 for lower eyelid grafts. Esthetic outcomes were determined using standardized photographs and a specific grading scale for eyelid FTSGs. RESULTS: Our study included 67 patients (males: 42, females: 25) who underwent 70 FTSG procedures, with a mean age of 69.7 years (range: 18-96). The average initial postoperative visit was at 14.2 days, and patients had an average of 1.2 clinical visits in the first 6 weeks. The improvements in MRD1, MRD2, and lagophthalmos were 1.7 mm (P = 0.002), 1.9 mm (P < 0.001), and 2.5 mm (P = 0.015), respectively. Esthetic outcomes were graded as "perfect" to "good" in 52 (74%) patients for graft color and edge, 50 (71.4%) for graft contour, and 64 (91.4%) for graft size and lid margin contour. Graft survival was 98.6%. The complication rate was 14.3%, with a mean follow-up of 13 months (range: 3-50). CONCLUSION: Various techniques are described in the literature with good results, some requiring extra costs, theater time, or clinical visits. Our technique replaces Frost sutures and bolsters, minimizing immediate postoperative visits while achieving high graft success with favorable functional and esthetic outcomes.

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