Outpatient skin grafting of extremity burn wounds with the use of Unna Boot compression dressings

Abstract

Thirty-one patients underwent split-thickness skin grafting for burn injuries of an extremity, after which Unna Boot compression dressings were applied for fixation of the graft. Three patients required hospitalization of 2 to 4 days, and 28 patients were treated strictly on an outpatient basis. The lower extremity was involved in 25 patients, and the upper extremity was involved in six. Average wound size was 284 cm2. Eighteen patients were treated with sheet grafts, and 13 received meshed grafts. Nine wounds extended across a joint. Patients were allowed immediate ambulation after surgery. All grafts resulted in 95% to 100% wound coverage, and no regrafting was required. Application of Unna boot compression dressings to extremity skin grafts provides excellent protection of both meshed and nonmeshed grafts and allows immediate ambulation and range of motion. Many patients with burn injuries may be treated on an outpatient basis with the use of this technique.