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Skin grafting has been used widely for various reconstructions. The complete survival of the skin graft is necessary for functional and aesthetic restoration, as incomplete survival delays wound healing and results in severe primary and secondary contraction of the graft and scar contractures. To promote successful skin grafting, bleeding of the recipient wound bed must be arrested during surgery and the graft must be appropriately compressed and completely fixed to prevent shearing against the wound bed. After the operation, it is necessary to maintain the compression force and fixation of the graft for at least 5–7 days. One of the difficulties associated with skin grafting is differences in recipient site conditions. Areas that are difficult to graft are mobile areas such as the joints and the neck, and areas that have a free border, such as the eyelids and the perioral area. The authors currently use the external wire-frame fixation method1-5 for reliable skin grafting, in particular when these areas are involved. This technique is useful for securing the graft to the wound bed and it prevents the graft edges from lifting. In addition, it can sometimes be used to fix joints at the same time. This technique is introduced and discussed in this chapter.

External Wire Frame Fixation for Skin Grafts