Regrafting of the Split-Thickness Skin Graft Donor-Site: Is It Beneficial?

Abstract Split-thickness skin grafting remains a fundamental treatment for patients with deep burns and other traumatic injuries. Unfortunately, the donor site wound that remains after split skin graft (SSG) harvesting may also cause problems for the patient; they can lead to discomfort and scars with a poor cosmetic outcome. Regrafting of the donor site is one of the methods described to improve donor site healing and scarring. In this report, we describe a case of a 26-year-old woman with a self-inflicted chemical burn (0.5% TBSA) who underwent split skin grafting. During surgery, only part of the donor site was regrafted with split skin graft remnants. This part healed faster and had a better scar quality at 3 months postsurgery. Nevertheless, the appearance and patients’ opinion on the regrafted part deteriorated after 12 months. With this case report, we aim to create awareness of the long-term consequences of regrafting, which may differ from short-time results. Patients expected to have poor reepithelialization potential may benefit from regrafting of the SSG on the donor site. But in healthy young individuals, timewise there would be no benefit since it can lead to an aesthetically displeasing result.

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The Split Skin Graft Donor Site: Can Pretreatment with Vitamin a Cream Help?

Canadian Journal of Plastic Surgery ◽

10.1177/229255030201000208 ◽

2002 ◽

Vol 10 (2) ◽

pp. 78-80

Author(s):

Pj Skoll ◽

M Soldin ◽

M Grob ◽

B Seymour ◽

J Davies ◽

...

Keyword(s):

Vitamin A ◽

Skin Graft ◽

Donor Site ◽

Skin Grafting ◽

Hot Water ◽

Split Skin Graft ◽

Clinical Criteria ◽

Split Thickness Skin Grafting ◽

Graft Donor ◽

Split Skin

Background A skin graft donor site that heals rapidly with less cosmetic sequelae is of particular benefit to children with burns. Vitamin A cream has been shown to speed up healing after controlled ‘burns’ (dermabrasion and CO2 laser) if it is applied six weeks before treatment. Objective To assess whether pretreatment with vitamin A cream increases the rate of healing of split skin graft donor sites in children with burns. Methods Prospective study of children with hot water burns of 8% to 30% that required split thickness skin grafting. Vitamin A cream was applied bidaily to one thigh and/or buttock of each child for five to seven days before skin grafting. At surgery, equal thickness grafts were harvested from both thighs and/or buttocks. Biopsies were taken from each thigh and/or buttock and were sent for histological analysis. The rate of donor site healing was monitored clinically and with serial photographs. Results No difference in the rate of healing was noted between the treated and untreated sides by either histological or clinical criteria. Conclusions Vitamin A cream applied bidaily for a period of five to seven days did not affect the healing rate of the split skin graft donor sites in children with burns.

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Necrotising fasciitis—A rare complication of split-thickness skin graft donor area

Journal of Surgical Dermatology ◽

10.18282/jsd.v2.i3.141 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Rahul Bamal ◽

Rakesh Kain

Keyword(s):

Rare Complication ◽

Donor Site ◽

Skin Grafting ◽

Necrotising Fasciitis ◽

Split Thickness Skin Graft ◽

Successful Management ◽

Thickness Skin ◽

Split Thickness Skin Grafting ◽

Donor Area ◽

Graft Donor

<p class="Default">Split-thickness skin grafting (STSG) is commonly used to cover raw areas of various aetiologies. Donor sites are known to get infected sometimes, but necrotising fasciitis is not often reported. We report here a case of donor-site necrotising fasciitis and its successful management. There is a need for surgeons to stay vigilant for this rare but probable complication of skin grafting.</p>

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GLABROUS & NON-GLABROUS SPLIT SKIN GRAFT IN THE RECONSTRUCTION OF FLEXION CONTRACTURE OF FINGERS – AN OBSERVATIONALAND COMPARATIVE STUDY.

10.36106/ijsr/6521990 ◽

2020 ◽

pp. 1-3

Author(s):

Abhishek Gaur ◽

Nidhi Gaur

Keyword(s):

Skin Graft ◽

Donor Site ◽

Donor Site Morbidity ◽

Flexion Contracture ◽

Split Thickness Skin Graft ◽

Skin Grafts ◽

Flexion Deformity ◽

Split Skin Graft ◽

Thickness Skin ◽

Split Skin

Background: Flexion contractures of the fingers cause functional and aesthetic problems to a burn patient. Various methods of reconstruction have been described in the literature. These include release and split thickness grafting, release and full thickness grafting. Among those incision or excision of the contracture band and split skin grafting were the simplest and commonest techniques. In this study, we aim to compare functional & aesthetic outcomes of glabrous & non glabrous split skin graft in flexion contracture of fingers. Methods: A total of 60 fingers of patients of post burn finger contractures were undertaken for the study. Patients were evaluated preoperatively on duration of contracture, extent of involvement, type of scar, range of movements using goniometer and degree of fixed flexion deformity. Finger contractures were released and resurfacing done with glabrous & non-glabrous split thickness skin grafts. Postoperative evaluation was done by measuring range of movements of Proximal Interphalangeal (PIP) and Distal interphalangeal (DIP) joints, flexion deformity, donor site morbidity, number of visits to the hospital, colour match of graft to adjacent skin. Results: Functional outcome in terms of active range of motion combined at DIP joint, PIP joint & metacarpophalangeal joint were similar in both glabrous split thickness skin graft & non glabrous split thickness skin graft at the end of six months. As compared with non-glabrous split thickness skin grafts, glabrous split thickness grafts provided superior colour & texture match to surround tissue. There was no significant donor site morbidity in plantar in-step area & patients were able to walk from third to fourth post operative day. There was minimal hypertrophy of plantar donor site, owing to persistent pressure in standing posture. Conclusion: Patient’s satisfaction was greater in glabrous split skin graft.

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Split-thickness skin graft donor-site morbidity: A systematic literature review

Burns ◽

10.1016/j.burns.2021.02.014 ◽

2021 ◽

Author(s):

Malachy Asuku ◽

Tzy-Chyi Yu ◽

Qi Yan ◽

Elaine Böing ◽

Helen Hahn ◽

...

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Skin Graft ◽

Donor Site ◽

Donor Site Morbidity ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor

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Diathermy of split-thickness skin graft donor site: a new technique

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2017.05.011 ◽

2017 ◽

Vol 55 (7) ◽

pp. 734-735 ◽

Cited By ~ 2

Author(s):

A.M. Holden ◽

A.N. Beech ◽

J.N. Farrier

Keyword(s):

Skin Graft ◽

Donor Site ◽

New Technique ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor ◽

A New Technique

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Use of Honey as an Adjunct in the Healing of Split-Thickness Skin Graft Donor Site

Dermatologic Surgery ◽

10.1097/00042728-200302000-00012 ◽

2003 ◽

Vol 29 (2) ◽

pp. 168-172

Author(s):

AYKUT MISIRLIOGLU ◽

SINEM EROGLU ◽

NACI KARACAOGLAN ◽

MITHAT AKAN ◽

TAYFUN AKOZ ◽

...

Keyword(s):

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor

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Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing

Plastic & Reconstructive Surgery Global Open ◽

10.1097/gox.0000000000001339 ◽

2017 ◽

Vol 5 (5) ◽

pp. e1339 ◽

Cited By ~ 6

Author(s):

Brian P. Bradow ◽

Geoffrey G. Hallock ◽

Samuel P. Wilcock

Keyword(s):

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Graft Donor

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CICAFAST: comparison of a biological dressing composed of fetal fibroblasts and keratinocytes on a split-thickness skin graft donor site versus a traditional dressing: a randomized controlled trial

Trials ◽

10.1186/s13063-019-3718-4 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Alexandra Poinas ◽

Pierre Perrot ◽

Judith Lorant ◽

Olivier Nerrière ◽

Jean-Michel Nguyen ◽

...

Keyword(s):

Wound Healing ◽

Growth Factors ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Skin Grafts ◽

Thickness Skin ◽

Fetal Fibroblasts ◽

Biological Dressing ◽

Graft Donor

Abstract Background Wound repair is one of the most complex biological processes of human life. Allogeneic cell-based engineered skin substitutes provide off-the-shelf temporary wound coverage and act as biologically active dressings, releasing growth factors, cytokines and extracellular matrix components essential for proper wound healing. However, they are susceptible to immune rejection and this is their major weakness. Thanks to their low immunogenicity and high effectiveness in regeneration, fetal skin cells represent an attractive alternative to the commonly used autologous and allogeneic skin grafts. Methods/design We developed a new dressing comprising a collagen matrix seeded with a specific ratio of active fetal fibroblasts and keratinocytes. These produce a variety of healing growth factors and cytokines which will increase the speed of wound healing and induce an immunotolerant state, with a slight inflammatory reaction and a reduction in pain. The objective of this study is to demonstrate that the use of this biological dressing for wound healing at the split-thickness skin graft (STSG) donor site, reduces the time to healing, decreases other co-morbidities, such as pain, and improves the appearance of the scar. This investigation will be conducted as part of a randomized study comparing our new biological dressing with a conventional treatment in a single patient, thus avoiding the factors that may influence the healing of a graft donor site. Discussion This clinical trial should enable the development of a new strategy for STSG donor-wound healing based on a regenerative dressing. The pain experienced in the first few days of STSG healing is well known due to the exposure of sensory nerve endings. Reducing this pain will also reduce analgesic drug intake and the duration of sick leave. Our biological dressing will meet the essential need of surgeons to “re-crop” from existing donor sites, e.g., for thermal-burn patients. By accelerating healing, improving the appearance of the scar and reducing pain, we hope to improve the conditions of treatment for skin grafts. Trial registration ClinicalTrials.gov, ID: NCT03334656. Registered on 7 November 2017.

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