Skin grafts in the periocular region without a bolstered dressing.

Purpose: To assess success and intervention rates for full-thickness skin grafts in the periocular region without the use of a sutured bolster dressing.

Methods: A clinical assessment of the long-term outcome in consecutive patients who underwent skin-grafting procedures without a bolstered dressing between 2003 and 2009 under a single surgeon (BP). All patients were independently clinically evaluated by two surgeons to assess final graft outcome. Data was collected on demographics, surgical indication, surgical technique, follow-up time and complications. The final clinical evaluation assessed graft thickness, color, contracture and lid position. Patient satisfaction was assessed using a visual analogue scale. Mean follow-up time was 27 months.

Results: Clinical review was possible in 35 out of 47 grafts carried out during the study period. There were no cases of postoperative graft ischemia or failure. Hematoma not affecting the final outcome occurred in two grafts and graft contraction requiring intervention occurred in only one patient. Patient satisfaction was high with an average score of 9/10.

Conclusion: We report a high success rate for periocular skin grafts without the use of a bolstered dressing. The use of a bolster increases operating time, postoperative care and is possibly less acceptable to the patient. We suggest that that in most cases the use of a bolster is not necessary for periocular skin grafts.