Artiss Sealant®: An Alternative to Stapling Skin Grafts on the Dorsal Side of the Hand and Fingers

The aim of this study was to evaluate the benefit of using a new slow-setting fibrin sealant compared with staples for adherence of split-thickness skin grafts on the backs of hands and fingers. Staple removal is often painful for patients. Twenty-eight patients were included for a graft total of 34 hands. The authors chose to test this sealant on zones that are often difficult to graft given their varied topographies. Its low concentration of thrombin (4 IU/ml) compared with other sealants provides it with prolonged polymerization time (60 seconds) making it easier to use in this location. All 34 grafts had taken at 5 days postoperatively and no graft required revision surgery. Six of our patients had sealant on one hand and staples on the other hand. All of the patients reported less pain on the sealant hand with a mean visual analog scale inferior to 2.6 times less (Mann–Whitney U test, P = .0035). Eighteen months after treatment, all of the patients had acceptable function and esthetic aspect of their hands with no difference noted between glued or stapled hands. The only notable drawbacks to the use of this sealant are the preparation and application time which is longer than with staples, the need to evacuate small seromas under the graft and obstruction of the drainage points by the sealant. The use of Artiss Sealant® enabled us to reduce the amount of care and to decrease the pain because there was no staple removal.