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Статті в журналах з теми "Split thickness skin graft"

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Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 29 січня 2023

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1

Vidrine, D. Macy, Steven Kaler, and Eben L. Rosenthal. "A Comparison of Negative-Pressure Dressings Versus Bolster and Splinting of the Radial Forearm Donor Site." Otolaryngology–Head and Neck Surgery 133, no. 3 (September 2005): 403–6. http://dx.doi.org/10.1016/j.otohns.2005.04.028.

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OBJECTIVE: Negative-pressure dressings (NPDs) have been reported to improve split-thickness skin graft survival in some settings; we assessed whether NPDs could improve skin graft results in radial forearm donor sites. METHODS: Between October 2003 and November 2004, 45 radial forearm donor sites underwent split-thickness skin graft immobilization either with conventional bolster dressing and splint or with an NPD. Split-thickness skin graft take was recorded at 1 and 4 weeks postoperatively. RESULTS: Overall split-thickness skin graft healing was improved in the NPD group (92%) compared with the case of conventional splinting (81%) at 4 weeks ( P =. 10). The rate of major graft loss was less in NPDs (10%) compared with the case of conventional management (28%) after 4 weeks ( P =. 06). CONCLUSIONS: Split-thickness skin graft survival was significantly improved by the use of NPDs. Because the use of NPDs is expensive, we consider their use only in patients with potential wound-healing problems, when there is a need to monitor the hand, or when immediate postoperative hand immobilization might impede the patient's recovery.

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2

Sun, Luxi, and Animesh JK Patel. "Outcomes of split vs full-thickness skin grafts in scalp reconstruction in outpatient local anaesthetic theatre." Scars, Burns & Healing 7 (January 2021): 205951312110565. http://dx.doi.org/10.1177/20595131211056542.

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Background Surgical excision remains the cornerstone of simultaneous diagnosis and treatment of suspicious skin lesions, and the scalp is a high-risk area for skin cancers due to increased cumulative lifetime ultraviolet (UV) exposure. Due to the inelasticity of scalp skin, most excisions with predetermined margins require reconstruction with skin grafting. Methods A retrospective single-centre cohort study was performed of all patients undergoing outpatient local anaesthetic scalp skin excision and skin graft reconstruction in the Plastic Surgery Department at Addenbrookes Hospital over a 20-month period between 1 April 2017 and 1 January 2019. In total, 204 graft cases were collected. Graft reconstruction techniques included both full-thickness and split-thickness skin grafts. Statistical analysis using Z tests were used to determine which skin grafting technique achieved better graft take. Results Split-thickness skin grafts had a statistically significant ( P = 0.01) increased average take (90%) compared to full-thickness skin grafts (72%). Using a foam tie-over dressing on the scalp led to a statistically significant ( P = 0.000036) increase in skin graft take, from 38% to 79%. Conclusion In skin graft reconstruction of scalp defects after skin cancer excision surgery, split skin grafts secured with foam tie-over dressings are associated with superior outcomes compared to full-thickness skin grafts or grafts secured with sutures only.

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3

Fowler, A., and A. Dempsey. "Split-thickness skin graft donor sites." Journal of Wound Care 7, no. 8 (September 2, 1998): 399–402. http://dx.doi.org/10.12968/jowc.1998.7.8.399.

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4

Rajendran, M. K. "Tumescent non-tumescent technique for split thickness skin graft harvesting." International Surgery Journal 5, no. 12 (November 28, 2018): 4026. http://dx.doi.org/10.18203/2349-2902.isj20185038.

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Background: Split-thickness skin graft failures can be attributed to flaws in the recipient bed which has to be well prepared. Tissues with limited blood supply such as bone, tendons, cartilage or sites with necrotic tissue or infection do not accept skin grafts. Adrenaline is used to harvest skin grafts due to its vasoconstriction effect which limits blood loss. The aim of our study was to determine skin graft take after tumescent technique compared to a non-tumescent technique for harvesting.Methods: Two treatment groups of patients who fulfilled the inclusion criteria were randomly assigned. Forty patients underwent split-thickness skin graft harvesting with tumescent technique and forty patients underwent non-tumescent split-thickness skin graft harvesting. The recipient site was opened in both groups on the fifth day after surgery and take rate assessed. The donor site was assessed on day ten and if not healed, followed up for three weeks.Results: There was a statistically significant association between skin graft take rate and skin grafting technique (p=0.011). The mean graft take rate was 2.5% higher in the tumescent group compared to the non-tumescent group (96.3% compared to 94%). On day 10, there was no difference in percentage healing of donor sites between the tumescent and non-tumescent groups, p=0.562.Conclusions: Tumescent technique significantly reduced intraoperative blood loss. It is safe, inexpensive and easy to use. The subdermal adrenaline/saline injection creates a smooth, dense surface which assists debridement and donor harvesting.

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5

Chucuan Garcia, Jorge Antonio, Jose Ochoa Martinez, Ricardo Espinoza Pere, Miguel Silva Garcia, and Irving Oswaldo Rodriguez Juarez. "Quick Overview of Skin Autografting." INTERNATIONAL JOURNAL OF MEDICAL SCIENCE AND CLINICAL RESEARCH STUDIES 02, no. 11 (November 3, 2022): 1195–98. http://dx.doi.org/10.47191/ijmscrs/v2-i11-01.

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A skin autograft is described as the transfer of skin without the aid of a blood supply from the donor location to the recipient site. The epidermis and portions of the underlying dermis from the donor location are transferred using split-thickness skin grafts (STSGs). The whole layer of skin is harvested for full-thickness skin grafts (FTSGs) and used as the transplant. The installation methods and usage of STSGs are discussed above. Graft movement, which impedes neovascularization and promotes fluid accumulation under the transplant, which can result in infection and inadequate revascularization, is the key factor in skin graft failure.

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6

Sanniec, Kyle, Tea Nguyen, Suzanne van Asten, Javier La Fontaine, and Lawrence A. Lavery. "Split-Thickness Skin Grafts to the Foot and Ankle of Diabetic Patients." Journal of the American Podiatric Medical Association 107, no. 5 (September 1, 2017): 365–68. http://dx.doi.org/10.7547/15-200.

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Background: There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. The purpose of this review was to determine whether elevated HbA1c levels are a contraindication to the application of skin grafts in diabetic patients. Methods: A retrospective review was performed of 53 consecutive patients who underwent split-thickness skin graft application to the lower extremity between January 1, 2012, and December 31, 2015. A uniform surgical technique was used across all of the patients. A comparison of HbA1c levels between failed and healed skin grafts was reviewed. Results: Of 43 surgical sites (41 patients) that met the inclusion criteria, 27 healed with greater than 90% graft take and 16 had a skin graft that failed. There was no statistically significant difference in HbA1c levels in the group that healed a skin graft compared with the group in which skin graft failed to adhere. Conclusions: Preliminary data suggest that an elevated HbA1c level is not a contraindication to application of a skin graft. The benefits of early wound closure outweigh the risks of skin graft application in patients with diabetes.

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7

DEUNK, J., J. P. A. NICOLAI, and S. M. HAMBURG. "Long-Term Results of Syndactyly Correction: Full-Thickness versus Split-Thickness Skin Grafts." Journal of Hand Surgery 28, no. 2 (April 2003): 125–30. http://dx.doi.org/10.1016/s0266-7681(02)00306-6.

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In order to compare the long-term results of full-thickness and split-thickness skin grafts after the correction of congenital syndactyly, 27 patients have been investigated after an average follow-up of 21 years. Post-operative functional and cosmetic results have been assessed by patient records, questionnaires and physical examination. The webs that had received split-thickness grafts showed more flexion and extension lags and the overall spreading of the operated fingers was significantly decreased compared to the control fingers. On the other hand, more re-operations because of web creep had to be performed after full-thickness grafts. Hyperpigmentation and hair growth in the grafts was found in most of the full-thickness grafts, while breakdown of the graft was found in some of the split-thickness grafts. Therefore, based on the results of this study, either full- or split-thickness skin grafts can be used when treating of congenital syndactyly.

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8

Noll, Friedhelm, and Friedhelm Schreiter. "Meshgraft Urethroplasty Using Split-Thickness Skin Graft." Urologia Internationalis 45, no. 1 (1990): 44–49. http://dx.doi.org/10.1159/000281658.

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9

Demirtas, Yener, and Seyhan Çenetoğlu. "Re: Modification of Split-Thickness Skin Graft." Annals of Plastic Surgery 51, no. 2 (August 2003): 223. http://dx.doi.org/10.1097/01.sap.0000073359.43636.9a.

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10

Fuller, David A. "Split Thickness Skin Graft to Lower Leg." Journal of Orthopaedic Trauma 30 (August 2016): S34. http://dx.doi.org/10.1097/bot.0000000000000605.

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11

Ford, Edgin, Alonge, and Ezatollah Hazrati. "Split-thickness skin graft from surgically removed autogenous skin." Plastic and Reconstructive Surgery 88, no. 1 (July 1991): 180. http://dx.doi.org/10.1097/00006534-199107000-00061.

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12

Wallner, Christoph, Jana Holtermann, Marius Drysch, Johannes Maximilian Wagner, Mehran Dadras, Alexander Sogorski, Maxi Sacher, Mustafa Becerikli, Marcus Lehnhardt, and Björn Behr. "554 A Comparison of Intact Piscine Skin, Split-thickness Skin Graft, and Lactic Acid Membrane in Treating Superficial and Deep Burn Wounds Following Enzymatic Debridement." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S125—S126. http://dx.doi.org/10.1093/jbcr/irab032.204.

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Abstract Introduction The optimal therapy for deep burn wounds is based on the principle of rapid necrectomy and coverage in order to achieve healing that is as scar-free as possible. The available infrastructure and the patient’s condition represent limitations. With enzymatic debridement, selective bedside debridement can now be performed, however the optimal cover after enzymatic debridement has not been elucidated to date. In this study we compare superficial dermal and deep dermal wounds, which are either covered with lactic acid membrane, piscine skin, or split-thickness skin graft. To validate our approach the healed burn wounds were examined for objective (elasticity, water content, sebum, wound healing) and subjective skin quality as part of our standard follow-up care. Methods In this study, 12 patients who had received piscine skin, lactic acid membrane, or split-thickness skin graft after enzymatic debridement were retrospectively examined objectively and subjectively for scar quality as part of follow-up care 12 months after the accident. The wound healing process was also documented. Results Acceleration of wound healing was observed with the application of piscine skin vs split-thickness skin graft or lactic acid membrane. Skin elasticity was comparable to that of split-thickness skin graft but significantly better than lactic acid membrane. The sebum production in wounds treated with piscine skin was higher compared to lactic acid membrane covered wounds. The water storage capacity in the piscine skin treated wounds was also significantly higher than in lactic acid membrane or split-thickness skin graft treated wounds. Using the POSAS score, an improvement in elasticity, thickness, pigmentation, and relief was shown in piscine skin treated wounds, as well as a reduction in pain and itching, compared to split-thickness skin graft or lactic acid membrane. Conclusions The use of intact piscine skin immediately following enzymatic debridement in burn wounds results in faster wound healing and better patient outcomes compared to split-thickness skin graft or lactic acid membrane.

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13

Frost, Joshua, Nathan Hallier, Tanir Moreno, Jared Covell, Ryan Keck, and John A. Griswold. "668 Fixation of Split-Thickness Skin Grafts with Liquid Adhesive and Fibrin Glue in Place of Staples." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S190—S191. http://dx.doi.org/10.1093/jbcr/irab032.314.

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Abstract Introduction A critical component of split-thickness skin grafting is the fixation of the skin graft to the wound site. Graft displacement can result in graft failure, especially during the initial 48–72 hours following application. The most common method of securing grafts is with the use of staples, sometimes with the addition of fibrin glue in order to aid both graft adhesion and homeostasis. The use of staples, however, is associated with significant levels of patient discomfort, especially during staple removal. A possible alternative to staples is the use of liquid adhesives, in combination with steri-strips, to anchor the edges of skin grafts to intact skin. Certain liquid adhesives, such as gum-based resins, are cheaper to use than staples and offer the potential to secure small split-thickness skin grafts without the associated pain of staples. In this pilot study, we examined the effectiveness of using a combination of gum-based resin (Gum Mastic-Storax-Msal-Alcohol), fibrin glue, and steri-strips to secure partial-thickness grafts in 8 patients without the use of staples or sutures. Methods Patients were included in the study who required split-thickness skin grafts to treat wounds involving less than or equal to 15% total surface body area and whose wounds were not located in areas prone to graft displacement, such as the axilla and groin. For each patient, skin grafts were secured using fibrin glue (sprayed over the entire wound), and a combination of liquid adhesive and steri-strips applied around the wound perimeter. The success of each graft was determined by the percentage of graft take. Results From January 1st, 2020 to April 30th, 2020, 8 patients were identified who fit the inclusion criteria. Five of the patients received grafts to their lower extremities, two patients received grafts to their upper extremities, and one of the patients received a graft to the torso. The average wound site that was grafted was 116.7 cm2. Average graft take among the 8 patients was 96.9%, with a range of 90%-100%. No complications at the graft site were noted, such as hematomas or any other event that resulted in graft displacement or failure. Conclusions The results of the study demonstrate that a combination of liquid adhesive, fibrin glue, and steri-strips, can be used as an effective alternative to staples in small split-thickness skin grafts. The use of liquid adhesive in place of staples was advantageous because it eliminated to need for staple removal, which resulted in less discomfort for the patient and less work for the nursing staff.

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14

Triana Junco, Paloma, Mariela Dore, Vanesa Nuñez Cerezo, Javier Jimenez Gomez, Miriam Miguel Ferrero, Mercedes Díaz González, Pedro Lopez-Pereira, and Juan Lopez-Gutierrez. "Penile Reconstruction with Skin Grafts and Dermal Matrices: Indications and Management." European Journal of Pediatric Surgery Reports 05, no. 01 (January 2017): e47-e50. http://dx.doi.org/10.1055/s-0037-1606282.

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Introduction The penis eventually needs specific cutaneous coverage in the context of reconstructive procedures following trauma or congenital anomalies. Local flaps are the first choice but are not always available after multiple previous procedures. In these cases, skin graft and dermal matrices should be considered. Materials and Methods This study was a retrospective review of the past 4 years of four patients with severe loss of penile shaft skin who underwent skin reconstruction. Dermal matrices and skin grafts were utilized. Dermal matrices were placed for a median of 4.5 weeks (3.0–6.0 weeks). The skin graft was harvested from the inner thigh region for split-thickness skin graft (STSG) and the inguinal region for full-thickness skin graft (FTSG). Results The four patients presented with complete loss of skin in the penile shaft. One patient had a vesical exstrophy, one had a buried penis with only one corpus cavernosum, one had a wide congenital lymphedema of the genitalia, and one had a lack of skin following circumcision at home. They underwent reconstruction with three patients undergoing split-thickness skin graft; two dermal matrices; and one full-thickness graft, respectively, thereby achieving a good cosmetic and functional result. There were no complications, and all the patients successfully accepted the graft. Conclusion Dermal matrices and skin grafts may serve as effective tools in the management of severe penile skin defects unable to be covered with local flaps.

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Chaudhari, Dr Ganesh, and Dr Satish Sonawane. "Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study." VIMS Health Science Journal 8, no. 2 (June 17, 2021): 58–61. http://dx.doi.org/10.46858/vimshsj.8202.

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Background: Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Materials & methods: A comparative study conducted in 30 patients with post burn neck contracture at Dr. Vasantrao Pawar Medical College, Nashik, during January 2015 to December 2020. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p<0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion: Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake.

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Chaudhari, Dr Ganesh, and Dr Satish Sonawane. "Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study." VIMS Health Science Journal 8, no. 2 (June 17, 2021): 58–61. http://dx.doi.org/10.46858/vimshsj.8202.

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Background: Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Materials & methods: A comparative study conducted in 30 patients with post burn neck contracture at Dr. Vasantrao Pawar Medical College, Nashik, during January 2015 to December 2020. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p<0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion: Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake.

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de Henau, Melissa, Anne Sophie Kruit, and Dietmar J. O. Ulrich. "Reconstruction of full thickness wounds using glyaderm in a single-staged procedure." Cell and Tissue Banking 22, no. 2 (February 23, 2021): 199–205. http://dx.doi.org/10.1007/s10561-021-09907-x.

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Abstract Introduction In large full-thickness skin defects, donor site morbidity limits the available thickness and surface of skin autografts and therefore only split-thickness skin grafts are possible for reconstruction. Dermal equivalents can be added to these split-thickness grafts to acquire an anatomically better skin reconstruction. Glyaderm is a human derived, acellular dermis and up until now has only been used in a two-staged procedure. This report describes results of a case series using Glyaderm and split-thickness skin grafts in a single-staged procedure. Methods Glyaderm was introduced in 2017 in Radboudumc (Nijmegen, The Netherlands). Glyaderm and autologous split-skin grafts were simultaneously applied to the wounds. In cases with large wound surfaces or wounds covering highly mobile areas, negative pressure wound therapy was additionally applied. The first ten cases were followed with regular intervals post-operatively, assessing graft take, scar appearance, post-operative wound problems and re-interventions. Results Patients were aged 3 weeks to 76 years-old. Treated skin surface varied from 1–16% total body surface. Wounds resulted from trauma (n = 4), burns (n = 4) or soft tissue infections (n = 2). Follow-up varied from 4 months to 1.5 years. No complications occurred after surgery. Average take rate was 98%. Two patients had a later re-intervention to further improve the aesthetic appearance of the scarred area. Conclusion Our first results with the application of Glyaderm in a single-staged procedure provided good healing, graft take and scar appearance. Glyaderm was found a suitable dermal substitute in the treatment of full thickness wounds.

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Ghanem, Tamer A., and Mark K. Wax. "A novel Split-Thickness Skin Graft Donor Site." Otolaryngology–Head and Neck Surgery 141, no. 3 (September 2009): 390–94. http://dx.doi.org/10.1016/j.otohns.2009.05.031.

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OBJECTIVE: To eliminate morbidity of the thigh split-thickness skin graft (STSG) donor site in forearm flaps, the feasibility of harvesting from an alternate site was assessed. STUDY DESIGN: Case series with planned data collection. SETTING: A tertiary care academic setting. SUBJECTS AND METHODS: Data were collected from patients undergoing forearm flap reconstruction over 13 months. The forearm flap harvesting procedure was modified to incorporate STSG harvest directly from the flap skin paddle. RESULTS: There were 66 patients in this cohort, with mean age of 62.6 years. There were 58 fasciocutaneous radial forearm free flaps (RFFFs), three osteocutaneous RFFF, three ulnar flaps, and two reverse-flow RFFFs. The majority of flaps were used for mucosal coverage (n = 54), but 12 flaps were used for external skin coverage. The mean forearm defect was 36.5 cm2 (12–77 cm2). Harvesting from the forearm skin paddle was successful in 64 patients (97%). Two patients required a thigh STSG; both patients were octogenarians with frail skin. CONCLUSION: A thigh STSG donor site, with its associated morbidities, can be eliminated in 97 percent of patients undergoing forearm flaps. Older patients with frail skin may require a thigh donor site.

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Schreiter, Friedhelm, and Friedhelm Noll. "Mesh Graft Urethroplasty Using Split Thickness Skin Graft or Foreskin." Journal of Urology 142, no. 5 (November 1989): 1223–26. http://dx.doi.org/10.1016/s0022-5347(17)39036-5.

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Ali A Ali, Yasir N Qassim, and Ali N Areef. "Vacuum-assisted closure dressing in split-thickness skin grafting." International Journal of Research in Pharmaceutical Sciences 10, no. 3 (July 12, 2019): 1735–40. http://dx.doi.org/10.26452/ijrps.v10i3.1364.

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Vacuum-assisted closure (VAC) has been applied to a variety of acute and chronic wounds that are difficult to manage, and is associated with improved wound healing outcomes. It involves the application of sub-atmospheric pressure in a controlled way to secure a split-thickness skin graft on the wound that has been sealed with an occlusive dressing.A study was conducted on the patients with a variety of indications for skin grafting, admitted to Azadi Teaching Hospital between March 2010 and August 2017. After the application of split-thickness skin graft, a closed, controlled suction was applied on the wound. The graft was then continuously observed, and the dressing was changed as needed.A total of 39 split-thickness skin grafting procedures were performed on 37 patients (20 male, 17 female), the age of the patients ranging between 7 and 68 years. The average grafted area was 12±70 cm2, and the percent graft take ranged from 90 - 100%.Vacuum-assisted closure opposes the graft firmly on the wound bed, sucks out the seroma and/or hematoma, prevents shearing of the graft and aids in immobilization of the grafted part; thus improving the quantity and quality of the graft take. This study also established that VAC was particularly useful when the wound site is difficult to access, the wound is highly contoured and the conditions are less-than-ideal for complete graft take.

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Ramanujam, Crystal L., John J. Stapleton, Krista L. Kilpadi, Roberto H. Rodriguez, Luke C. Jeffries, and Thomas Zgonis. "Split-Thickness Skin Grafts for Closure of Diabetic Foot and Ankle Wounds." Foot & Ankle Specialist 3, no. 5 (July 14, 2010): 231–40. http://dx.doi.org/10.1177/1938640010375114.

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The aim of this study was to determine if split-thickness skin grafts could be successfully used for closure of foot and ankle wounds in diabetic patients. The authors retrospectively reviewed the charts of 100 consecutive patients who underwent a soft tissue surgical reconstruction with split-thickness skin grafts to their foot and/or ankle in our institution from 2005 to 2008. After application of inclusion criteria, 83 eligible charts remained. Of the 83 patients, 54 (65%) healed uneventfully, 23 (28%) required regrafting, and 6 (7%) had a complication resolved with conservative management. All patients had a successful surgical outcome, defined as having achieved complete wound closure at the final follow-up. Surgical outcome was not significantly associated with age, gender, race, hemoglobin A1C, wound size, wound location, illicit drug use, amputation history, Charcot history, or preoperative infection. However, postoperative graft complications were significantly associated with current or previous smoking history (P = .016) and the level of previous pedal amputation to which the split-thickness skin graft was applied (P = .009). This study demonstrates that application of split-thickness skin grafts with an appropriate postoperative regimen is a beneficial procedure to achieve foot and ankle wound closure in diabetic patients.

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Jalili, Reza B., Amir Pourghadiri, Yunyuan Li, Chantell Cleversey, Ruhangiz T. Kilani, and Aziz Ghahary. "Split Thickness Grafts Grow From Bottom Up in Large Skin Injuries." Journal of Burn Care & Research 40, no. 6 (July 17, 2019): 727–33. http://dx.doi.org/10.1093/jbcr/irz123.

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Abstract Autologous split thickness skin graft is necessary for the survival of patients with large burns and skin defects. It is not clear how a thin split thickness skin graft becomes remarkably thicker within a few weeks following transplantation. Here, we hypothesized that growth of split thickness graft should be from bottom up probably through conversion of immune cells into collagen producing skin cells. We tested this hypothesis in a preclinical porcine model by grafting split thickness meshed skin (0.508 mm thickness, meshed at 3:1 ratio) on full thickness wounds in pigs. New tissue formation was evaluated on days 10 and 20 postoperation through histological analysis and co-staining for immune cell markers (CD45) and type I collagen. The findings revealed that a split thickness graft grew from bottom up and reached to almost the same level as uninjured skin within 60 days postoperation. The result of immune-staining identified a large number of cells, which co-expressed immune cell marker (CD45) and collagen on day 10 postoperation. Interestingly, as the number of these cells reduced on day 20, most of these cells became positive for collagen production. In another set of experiments, we tested whether immune cells can convert to collagen producing cells in vitro. The results showed that mouse adherent immune cells started to express type 1 procollagen and α-smooth muscle actin when cultured in the presence of fibroblast conditioned media. In conclusion, the early thickening of split thickness graft is likely happening through a major contribution of infiltrated immune cells that convert into mainly collagen producing fibroblasts in large skin injuries.

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Hallock, Geoffrey G. "The Cosmetic Split-Thickness Skin Graft Donor Site." Plastic and Reconstructive Surgery 104, no. 7 (December 1999): 2286–88. http://dx.doi.org/10.1097/00006534-199912000-00059.

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Yenidünya, Oğuz M., Emre Özdengil, and Murat I. Emsen. "SPLIT-THICKNESS SKIN GRAFT FIXATION WITH SURGICAL DRAPE." Plastic and Reconstructive Surgery 106, no. 6 (November 2000): 1429–30. http://dx.doi.org/10.1097/00006534-200011000-00046.

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25

McGhee, James T., Ayman Saeed, and Matt Erdmann. "A Technical Point for Split Thickness Skin Graft." Plastic and Reconstructive Surgery - Global Open 7, no. 4 (April 2019): e2223. http://dx.doi.org/10.1097/gox.0000000000002223.

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HENDI, ALI, and DAVID G. BRODLAND. "Split-Thickness Skin Graft in Nonhelical Ear Reconstruction." Dermatologic Surgery 32, no. 9 (September 2006): 1171–73. http://dx.doi.org/10.1097/00042728-200609000-00010.

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HENDI, ALI, and DAVID G. BRODLAND. "Split-Thickness Skin Graft in Nonhelical Ear Reconstruction." Dermatologic Surgery 32, no. 9 (September 2006): 1171–73. http://dx.doi.org/10.1111/j.1524-4725.2006.32259.x.

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28

Wettstein, Reto, Evelyn-Evanthia Betsi, Christophe Racine, Wassim Raffoul, and Daniel F. Kalbermatten. "Split-Thickness Skin Graft Harvested With Saline Moistening." Journal of Burn Care & Research 32, no. 1 (January 2011): e13. http://dx.doi.org/10.1097/bcr.0b013e318203353b.

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29

Engelhardt, Timm O., Gabriel Djedovic, Gerhard Pierer, and Ulrich M. Rieger. "Optimal Lubricant for Split-Thickness Skin Graft Harvest." Journal of Burn Care & Research 33, no. 3 (2012): e177-e178. http://dx.doi.org/10.1097/bcr.0b013e31823346e5.

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30

Woo, V., C. Pulse, A. Yoon, W. Pochal, V. D’Agati, and D. Zegarelli. "Amyloid Deposition in a Split-Thickness Skin Graft." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 103, no. 4 (April 2007): e25. http://dx.doi.org/10.1016/j.tripleo.2006.12.060.

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Holcomb, George. "Extragenital split thickness skin graft for urethral reconstruction." Journal of Pediatric Surgery 20, no. 1 (February 1985): 102. http://dx.doi.org/10.1016/s0022-3468(85)80443-7.

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32

Retrouvey, Helene, Alexander Adibfar, and Shahriar Shahrokhi. "Extremity Mobilization After Split-Thickness Skin Graft Application." Annals of Plastic Surgery 84, no. 1 (January 2020): 30–34. http://dx.doi.org/10.1097/sap.0000000000001993.

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33

Karlsson, Matilda, Margareta Lindgren, Ingmarie Jarnhed-Andersson, and Erkki Tarpila. "Dressing the Split-Thickness Skin Graft Donor Site." Advances in Skin & Wound Care 27, no. 1 (January 2014): 20–25. http://dx.doi.org/10.1097/01.asw.0000437786.92529.22.

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34

Titley, O. G., and A. P. Armstrong. "Full-thickness/split-thickness skin grafts." British Journal of Oral and Maxillofacial Surgery 32, no. 5 (October 1994): 341. http://dx.doi.org/10.1016/0266-4356(94)90093-0.

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35

Farhat ul Ain Tayyaba, Saleha Zafar, Sara Reza, Saima Mazhar, Tabinda Yasmine, and Sana Ajmal. "Plasma rich platelet efficacy in healing of chronic wounds." Professional Medical Journal 29, no. 06 (May 31, 2022): 855–58. http://dx.doi.org/10.29309/tpmj/2022.29.06.6291.

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Objective: To determine the effect of platelets rich plasma in healing of chronic wounds. Introduction: In Medical specialties, The purpose of this study is to find out platelet growth factor from plasma rich platelet that could accelerate the spilt thickness of skin graft survival. Study Design: Randomized Control Trial. Settings: Medical Unit-I, Plastic Surgery Ward at Bahawal Victoria Hospital Bahawalpur in Collaboration with Pathology Department, Quaid-e-Azam Medical College, Bahawalpur. Period: January 2020 to July 2020. Material & Methods: In this study fifty patients of split thickness of skin graft were enrolled which having remain clinical reasons and Plasma rich platelet were collected by aphaeresis and applied immediately. PRP therapy was applied only on 30 patients while 20 patients were taken as standard control PRP was applied on 30 patients and followed them for 6 weeks. We start observation of PRP therapy from the 1st dressing till the time of wound healing. Results: we have observed 100% up taken graft in patients who have received PRP therapy while in control group observed 4 patients showed complete graft loss 7 patients showed partial and 9 shoed complete uptake. Conclusion: This study demonstrated promising results to split thickness skin grafts by the application of Plasma rich platelets (PRP).

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36

Palmieri, Tina L. "Emerging Therapies for Full-Thickness Skin Regeneration." Journal of Burn Care & Research 44, Supplement_1 (December 26, 2022): S65—S67. http://dx.doi.org/10.1093/jbcr/irac102.

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Abstract The classical treatment of extensive full-thickness skin loss due to trauma or burns has been the split-thickness skin graft. While split-thickness skin grafts close the wound, they leave patients with visible scars, dry skin, pruritis, pain, pigmentation alterations, and changes in sensation. The optimal replacement for full-thickness skin loss is replacement with intact full-thickness skin. New technologies combined with advances in the understanding of the mechanisms behind wound healing have led to the development of techniques and products that may eventually recapitulate the functions, appearance, and physical properties of normal skin. Autologous homologous skin constructs, minimal functional skin units, and composite bioengineered skin with dermal substitutes all represent potential avenues for full-thickness composite skin development and application in extensive wounds. This article summarizes the progress, state, and future of full-thickness skin regeneration in burn and massive wound patients.

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Kubota, Yoshitaka, Nobuyuki Mitsukawa, Kumiko Chuma, Shinsuke Akita, Yoshitaro Sasahara, Naoaki Rikihisa, and Kaneshige Satoh. "Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting." Burns & Trauma 4 (May 5, 2016): 1–11. http://dx.doi.org/10.1186/s41038-016-0039-7.

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Abstract Background Early excision and skin grafting are commonly used to treat deep dermal burns (DDBs) of the dorsum of the hand. Partial-thickness debridement (PTD) is one of the most commonly used procedures for the excision of burned tissue of the dorsum of the hand. In contrast, full-thickness debridement (FTD) has also been reported. However, it is unclear whether PTD or FTD is better. Methods In this hospital-based retrospective study, we compared the outcomes of PTD followed by a medium split-thickness skin graft (STSG) with FTD followed by a thick STSG to treat a DDB of the dorsum of the hand in Japanese patients. To evaluate postoperative pigmentation of the skin graft, quantitative analyses were performed using the red, green, and blue (RGB) and the hue, saturation, and brightness (HSB) color spaces. We have organized the manuscript in a manner compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results Data from 11 patients were analyzed. Six hands (five patients) received grafts in the PTD group and eight hands (six patients) received grafts in the FTD group. Graft take was significantly better in the FTD group (median 98 %, interquartile range 95–99) than in the PTD group (median 90 %, interquartile range 85–90) (P < 0.01). Quantitative skin color analyses in both the RGB and HSB color spaces showed that postoperative grafted skin was significantly darker than the adjacent control area in the PTD group, but not in the FTD group. Conclusions There is a possibility that FTD followed by a thick STSG is an option that can reduce the risk of hyperpigmentation after surgery for DDB of the dorsum of the hand in Japanese patients. Further investigation is needed to clarify whether the FTD or the thick STSG or both are the factor for the control of hyperpigmentation.

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Tzarnas, Chris D. "Simple Sutureless Skin Graft Fixation." American Surgeon 65, no. 1 (January 1999): 86–87. http://dx.doi.org/10.1177/000313489906500120.

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A simple method to enhance split-thickness skin graft immobilization without sutures is described. The method uses collodion to secure a mesh gauze to the adjacent skin preventing skin graft dislodgment. The technique is rapid and efficient.

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39

Zhang, Min-Xia, Wei-Qiang Tan, Qing-Qing Fang, Chun-Ye Chen, and Jian-Min Yao. "Clinical Application of Split-Thickness Skin with Pedicle for Finger Wounds." BioMed Research International 2018 (June 27, 2018): 1–4. http://dx.doi.org/10.1155/2018/9470198.

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Background. Skin grafts and pedicled flaps are the traditional methods of reconstructing injuries; both have some disadvantages. Here, we introduce a new clinical application of split-thickness skin with pedicle for repairing finger wounds. Methods. We present the new method of split-thickness skin with pedicle used on 12 patients (18 fingers) between 2012 and 2016. The graft was sketched on the abdomen at random according to the shape of the wounds on a skin area of 1.0 × 1.0 cm–8.0 × 1.5 cm. The pedicle was divided at 7–22 days. Results. During the follow-up time of 13–20 months, there were no reported cases of skin necrosis; 17 fingers obtained primary healing except 1, which required a dressing change. Conclusion. The split-thickness skin with pedicle proved to be valuable in the treatment of finger wounds and has the advantages of both pedicled flaps and free skin grafting.

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Zieske, Larry A., Jonas T. Johnson, Eugene N. Myers, Victor L. Schramm, and Robin Wagner. "Composite Resection Reconstruction: Split-Thickness Skin Graft—A Preferred Option." Otolaryngology–Head and Neck Surgery 98, no. 2 (February 1988): 170–73. http://dx.doi.org/10.1177/019459988809800212.

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In dealing with reconstruction of the oral cavity postcomposite resection, many options are available. Maximization of function with minimization of complications, physiologic sequelae, and cost must be considered. Fifty consecutive patients who underwent composite resections and were reconstructed by split-thickness skin grafts were analyzed. Factors examined included: number of blood units transfused, disease status vs. stage, length of hospital stay, complications, use of prosthetic devices for aiding in swallowing and speech production, and patient diet at discharge. This evaluation and literature review revealed that the amount of tissue resection was considered to be the most significant functional determinant, followed by maintenance of residual tissue mobility. The use of a split-thickness skin graft was believed to give excellent results for the previously mentioned parameters and is our preferred method for reconstruction of composite resection defects that do not require tissue bulk as in anterior mandible defects, anticipated mandible reconstruction, total or near-total glossectomy, or very massive defects.

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Egro, Francesco M., Eva Roy, Anisha Konanur, Carolyn Murphy, Alain C. Corcos, and Jenny A. Ziembicki. "789 Split-thickness Skin Graft Meshing: The True Mesh Ratio." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S229—S230. http://dx.doi.org/10.1093/jbcr/iraa024.366.

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Abstract Introduction Skin graft meshing is frequently used to allow coverage of extensive wound areas, reduction of donor site size, and prevention of fluid accumulation underneath the skin graft. Meshers allow for various ratios to be used but no studies have confirmed the accuracy of the mesh ratio provided by the manufacturers. The objective of this study was to measure the true mesh ratio achieved using some of the most commonly used skin meshers. Methods A prospective cohort study was performed in 2019. The true expansion ratio was calculated for standardized human split-thickness skin grafts (4x4cm harvested 0.0012in depth using an air dermatome) of the most commonly used meshing ratios (1:1, 1:5:1, 2:1, 3:1, 4:1, and 6:1). Results We had a total of 18 patients resulting in 86 measurements. The study population consisted of 12 males and 6 females; 89% white, 11% non-white; average age of 43 years (SD 21.2). The true mesh ratios of 1:1, 1.5:1, 2:1, 3:1, 4:1, and 6:1 meshers were found to be 1.20 (SD 0.14), 1.55 (SD 0.32), 1.68 (SD 0.32), 2.62 (SD 0.51), 2.87 (SD 0.92), 4.94 (SD 1.35), respectively. The percent errors were 20.2%, 3.3%, -15.8%, -12.5%, -28.3%, -17.7% respectively. Conclusions Mesh ratios of 2:1 meshers and above established by manufacturers are inaccurate. Therefore, overestimation of 2:1 meshers and above is recommended. We recommend an overestimation of 10% or more for meshers 2:1 and above. Applicability of Research to Practice This has significant applicability to practice as it can affect surgical decisions related to estimating the extent of donor area needed to cover skin and soft tissue defects.

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42

Wladecki, Mark J., and Michael D. Maves. "???Split??? Full-Thickness Skin Grafts." Laryngoscope 101, no. 11 (November 1991): 1226???1228. http://dx.doi.org/10.1288/00005537-199111000-00012.

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Thimmanahalli, Girish Umashankar, and Mahesh Kumar. "Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting." International Surgery Journal 6, no. 1 (December 27, 2018): 108. http://dx.doi.org/10.18203/2349-2902.isj20185099.

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Background: Platelet-Rich Plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. After skin graft reconstruction, the healing process is longer and may be difficult, depending on the wound site, skin defect size, and patient comorbidities. The potential value of PRP lies in its ability to incorporate high concentrations of platelet-derived growth factors into the skin graft. Since not all patients afford commercially available recombinant platelet rich plasma for skin graft, platelet extract from patient’s own blood is being used in this study to test and demonstrate the therapeutic role of PRP in skin graft. The aim of this randomized, prospective study is to compare the effectiveness of PRP in skin graft with conventional method like sutures, staplers or glue.Methods: The source of data were the patients admitted as inpatients for the management of wounds to the department of general surgery, JSS Hospital, Mysore from September 2016 to September 2018. Total of 60 patients were studied; 30 cases were randomly chosen for study with autologous platelet rich plasma and 30 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group.Results: Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group.Conclusions: The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

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44

Limarda, Helen, Tamia Asri Jeser, Johanes Andrew, Rokhim Suryadi, and Teddy Tjahyanto. "Evaluation of skin natural change function in split-thickness skin graft." Science Midwifery 10, no. 5 (December 29, 2022): 4399–406. http://dx.doi.org/10.35335/midwifery.v10i5.1064.

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Treatment for severe burns has improved rapidly in the last 20 years. Nowadays, patients can survive with burns covering up to approximately 90% of the body, although they often face permanent physical impairment. This type of research is a literature review. A literature review was conducted to gather information regarding the evaluation of skin natural change function in the split-thickness skin graft. This research is a type of review article that aims to obtain information about acne based on bio-markers. Source of data used secondary sources. The method of data collection through collecting data was from research articles taken within the last five years. Skin grafting remains an essential step on the reconstructive surgeon ladder. Meanwhile, the basic premise has remained similar results over the years. New techniques and devices have contributed to significantly improved functional and aesthetic results. Advances in the production of skin substitutes have provided better options to treat patients and will continue to be an essential and dynamic component of this field in the future.

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45

Kashif, Hassan, Shazia Manzoor, Mahak Ali, Aiman Naseem, Saba Kiran, and Syed Aaqil Shah. "Results of Split Thickness Skin Grafts after Scalp Rotation Flap Surgeries: A Cross-Sectional Study." Pakistan Journal of Medical and Health Sciences 16, no. 6 (June 30, 2021): 866–68. http://dx.doi.org/10.53350/pjmhs22166866.

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Aim: To assess outcome of Split thickness skin grafts after scalp rotation flap Surgeries. Study design: A cross-sectional study Place and Duration:This study was conducted at Patel Hospital Karachi Pakistan fromFebruary 2021 to February 2022. Methodology: This study aimed to assess clinical features, patient demographics, results, and long-term follow-up to identify its effectiveness in other procedures. A total of 15 individuals were incorporated in the present study, those who had combination scalp reconstruction and cranioplasty with anSplit thickness skin graftsfor local donor site covering. Before surgery, five patients (33.3 %) were classified as having "high complexity" scalp abnormalities. Six (40 %) patients were large, while 9 (60 %) were medium size. The remaining grafts were inset over bare Calvarial bone, while 10 (66.7%) were inset over vascularized muscle or pericranium. Results: The authors observed that all Split thickness skin grafts in this group were successful 93.3 % of the time (14/15). Due to poor take, grafts failed were observed in 1 patient. Because of the excellent success rate in this series, no patient risk factors were observed to be associated with transplant failure. Furthermore, whether the graft resided over bone or vascularized muscle/pericranium did not affect the success rate. Conclusion: Cranioplasty poses a challenge to surgeons. Split thickness skin Grafting has shown more promising results with simple techniques than other multifaceted reconstructive methods. Keywords:Calvarial bone, Cranioplasty, Split thickness skin grafts ,Percranium, Skin grafts

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46

Inatomi, Yusuke, Hideki Kadota, Kenichi Kamizono, Masuo Hanada, and Sei Yoshida. "Securing split-thickness skin grafts using negative-pressure wound therapy without suture fixation." Journal of Wound Care 28, Sup8 (August 2019): S16—S21. http://dx.doi.org/10.12968/jowc.2019.28.sup8.s16.

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Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group. Methods: Patients with STSGs were divided into two groups: a ‘no suture’ group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures. Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes). Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients.

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47

Haidar, Yarah M., Sartaaj Walia, Ronald Sahyouni, Yaser Ghavami, Harrison W. Lin, and Hamid R. Djalilian. "Auricular Split-Thickness Skin Graft for Ear Canal Coverage." Otolaryngology–Head and Neck Surgery 155, no. 6 (October 3, 2016): 1061–64. http://dx.doi.org/10.1177/0194599816667929.

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48

Kim, Sang Wha, Seung Hyup Choi, Jeong Tae Kim, and Youn Hwan Kim. "An Additional Option for Split-Thickness Skin Graft Donors." Annals of Plastic Surgery 75, no. 6 (December 2015): 634–36. http://dx.doi.org/10.1097/sap.0000000000000143.

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49

Dornseifer, Ulf, Daniel Lonic, Tristan Ivo Gerstung, Frank Herter, Andreas Max Fichter, Charlotte Holm, Tibor Schuster, and Milomir Ninkovic. "The Ideal Split-Thickness Skin Graft Donor-Site Dressing." Plastic and Reconstructive Surgery 128, no. 4 (October 2011): 918–24. http://dx.doi.org/10.1097/prs.0b013e3182268c02.

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50

HUANG, YU-HUEI, SHU-HUI WANG, TSENG-TONG KUO, and CHING-CHI CHI. "Pemphigus Vegetans Occurring in a Split-Thickness Skin Graft." Dermatologic Surgery 31, no. 2 (February 2005): 240–43. http://dx.doi.org/10.1097/00042728-200502000-00023.

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