TriVerse versus molecular resonance–harvested grafts in single-stage Baha surgery

Abstract

Objectives: To assess complications occurring in patients with a bone-anchored cochlear stimulator (Baha) following split-thickness skin graft harvested with two surgical modalities: the TriVerse (TV) system and the molecular resonance generator (MR). Study Design: Prospective, randomized, two-group (TV and MR) study of 24 patients who underwent Baha surgery. Setting: Tertiary care institution. Subjects and Methods: All patients (5 children, age range 6-14 yrs, median 8.3 yrs, and 16 adults, age range 30-73 yrs, median 60 yrs) underwent the one-stage procedure. The skin flap was harvested by use of the TV in 12 cases (2 children, 10 adults) and the MR generator in 12 (3 children, 9 adults). The main outcome measures were wound healing time, number of follow-up visits, degree of soft tissue reactions around the abutment, and need for revision surgery were examined. Results: There was a clear difference between the TV- and MR-harvested skin graft groups in relation to severity of skin reactions and complete healing time. The TV group required from three to seven (median 4) visits as outpatients during the initial observation period until healing was complete. The MR group required only one to three (median 2) visits. Complete healing time was significantly lower in the MR group (range 7-12 days, median 10 days) compared to the TV group (range 15-28 days, median 16 days). In the TV group, two patients required in-office revision of the skin graft because of partial necrosis. Conclusions: In our experience, the MR-harvested split-thickness skin graft is superior to the TV technique.