To observe the clinical effect of medical tissue adhesive in fixing large sheet autologous split-thickness skin grafts.

A retrospective study was conducted on the clinical data of 196 patients who underwent large sheet autologous split-thickness skin grafting，including acellular allodermal matrix composite split-thickness skin grafting for wound repair，and were hospitalized in the Department of Burns and Dermatologic Surgery， Xijing Hospital of Air Force Medical University， from February 2021 to June 2024. According to the different skin graft fixation methods， patients were divided into the observation group （n=104） and the control group （n=92）. In the observation group， skin grafts were fixed with medical tissue adhesive， the first dressing change was performed at 4-5 days postoperatively for simple split-thickness skin grafting， and 8-10 days postoperatively for acellular allodermal matrix composite split-thickness skin grafting. In the control group，skin grafts were fixed with skin suture needles for patients undergoing simple split-thickness skin grafting，and the skin grafts were fixed with interrupted silk sutures for patients undergoing acellular allodermal matrix composite split-thickness skin grafts， the first dressing change time after surgery was the same as that in the observation group. The occurrence of skin graft displacement， hematoma formation， infection， and the survival of skin graft were observed during the first dressing change.

The incidence of skin graft displacement in the observation group （4.8%） was lower than that in the control group （13.0%）， and the proportion of displaced skin graft area （3.63%±1.38%） was also lower than that in the control group （6.60%±2.08%）, the differences were statistically significant （P<0.05）. There was no statistically significant difference in skin graft survival rate between the observation group （99.24%±3.55%） and the control group （97.77%±6.08%） （t=2.046， P=0.151）. In the observation group， 5 cases of hematoma and 2 cases of skin graft infection with necrosis occurred， while in the control group， 4 cases of hematoma and 3 cases of skin graft infection with necrosis occurred. There was no statistically significant difference between the two groups （P>0.05）. Among the patients who developed complications，4 in the observation group and 5 in the control group healed after undergoing additional skin grafting； the remainder healed with dressing changes.

Compared with traditional fixation methods， medical tissue adhesive for securing large sheet autologous split-thickness skin grafts demonstrates more stable and effective fixation， reduces skin graft displacement， and avoids operational injuries and pain caused by removing fixatives. It is worthy of clinical promotion and application.