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Skin Transplantation

Theory

Authors: Christian Kaare Paaskesen Med. Stud, Eirini Tsigka, MD, MSc and Magnus Avnstorp, MD.

Definition

A skin graft that include the entire epidermis, but only a variable amount of dermis.  

Introduction

Split-skin grafts lack adnexal structures and presents semitransparent and smooth. When harvesting split-skin grafts, the innate vasculature of the graft is lost. After being places at the donor site, it takes 3-5 days until the graft have revascularized (1).

Donor site is usually the medial and lateral thighs, as this area is widely accessible for both the patient and surgeon, if a more cosmetic result is preferred buttocks can be used instead.

The cosmetic result of split-thickness skin grafts is non satisfying, as contraction, hypo- and hyperpigmentation of various levels may occur on both the recipient and donor site(1, 2). 

Note that the thinner the split-skin graft is, the greater the secondary contracture(3).

Indication

Split-skin grafts provide rapid wound coverage to large defects that lack adequate recipient bed vascularity. Because of reduced nutritional need, split-thickness skin grafts provide a better survival rate compared to full-thickness skin grafts.

References

  1. Adams DC, Ramsey ML. Grafts in dermatologic surgery: review and update on full- and split-thickness skin grafts, free cartilage grafts, and composite grafts. Dermatol Surg. 2005;31(8 Pt 2):1055-1067. doi:10.1111/j.1524-4725.2005.31831
  2. Shimizu R, Kishi K. Skin graft. Plast Surg Int. 2012;2012:563493. doi:10.1155/2012/563493
  3. Thorne, Charles Hm et al, Grabb and Smith’s Plastic Surgery (Wolters Kluwer, 7th ed, 2013;2014;)
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Procedures

Procedures