Small-slice thin-thickness skin harvesting in a net pattern for patients with skin vulnerability

Abstract

Introduction: A number of issues, such as delayed epithelialization and ulcer outbreak, may occur after epithelialization, especially in patients with skin vulnerability. This case report examines whether our method involving small-slice thin-thickness skin harvesting in a net pattern can enhance stable epithelialization at skin graft donor sites without complications, even in patients with skin vulnerability. Patients and methods: The study population consisted of five patients with skin vulnerability. The causes of injury were trauma and peripheral arterial disease (PAD). The study population included no patients with burn injuries. We applied a new skin harvesting method in these patients from July 2011 to December 2016. Thin-thickness skin grafts as small slices were harvested from the lateral thigh using a small freehand dermatome. Intact skin gaps between the harvested areas were preserved in a net pattern. The donor site was monitored continuously. Results: The mean size of the donor site was 122.9 cm2, and that of the recipient site was 206.9 cm2. The mean period until epithelialization was 13.2 days with a range of 11–15 days without ulcer outbreak. Hypertrophic scars and pigmentation occurred in one patient each. There were no other complications in this case report. Conclusion: Small-slice thin-thickness skin harvesting in a net pattern is a very simple and useful skin harvesting method for dealing with thin, loose, and fragile skin. This method can be adapted to some burn patients with skin vulnerability because it can reduce the complications at the donor site and it allows harvesting multiple times at the same site. Keywords: Skin graft, Donor site, Wound healing, Net pattern, Skin vulnerability