Tie-over bolster dressings vs basting sutures for the closure of full-thickness skin grafts: A review of the literature

William Kromka, Michael Cameron, Ramin Fathi

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Background: Full-thickness skin grafting is a well-established technique in the reconstruction of various tissue defects and wounds. However, lack of uniformity in the procedure of closing and securing the grafts has led to a wide range of different techniques. Objective: This article reviews the use of tie-over bolster dressings compared to basting sutures for the fixation and postsurgical immobilization of full-thickness skin grafts (FTSGs), discusses details of each method, and proposes a practice guideline for the closure of FTSGs. Methods: A traditional review of the literature was performed through a search of PubMed using the following keywords: full-thickness skin graft, FTSG, closure, suture, tie-over bolster, quilting, and bolster. Results: The current literature regarding tie-over bolster dressings does not demonstrate improved outcomes compared to quilting sutures. The 2 techniques appear equivalent in terms of utility and outcome, both possessing distinct advantages and disadvantages. Conclusion: Despite minimal head-to-head studies between tie-over bolsters and quilting, the best evidence from the literature appears to show comparable results regarding graft take, cosmetic outcomes, and postoperative complications. Ultimately, the choice of using a tie-over bolster technique or quilting sutures relies on surgeon preference and anatomic location.

Original languageEnglish
Pages (from-to)602-606
Number of pages5
JournalJournal of Cutaneous Medicine and Surgery
Issue number6
StatePublished - 1 Jun 2018
Externally publishedYes


  • Basting suture
  • Dermatology
  • Full-thickness skin graft
  • Surgery
  • Tie-over bolster


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