Abstract
Skin grafting has been a tool in the reconstructive surgeon’s armamentarium for centuries. Modern technological advances such as the engineering of dermal substitutes to help prime a wound bed for grafting and the development of the vacuum-assisted closure device for securing the graft to the recipient site both have a common goal: the provision of a timely, durable closure means of wound closure with satisfactory aesthetic result with minimal donor site morbidity. For a wound to be suitable for a skin graft, it must be adequately debrided of infected and devitalized tissue and have an adequate blood supply to support the nascent graft. Full-thickness skin grafts include the epidermis and entire dermis of the donor site, and these grafts are usually used for smaller defects where thicker coverage or close color and texture match is desired. Split-thickness skin grafts are composed of partial thickness of the dermis in addition to the epidermis and are often meshed to help expand the size of the graft and to facilitate drainage of fluid from underneath the graft. The ultimate “take” of the skin graft is dependent upon a well-vascularized, infection-free recipient site, close apposition of the graft to the recipient wound bed, and appropriate immobilization of the graft to allow inosculation and neovascularization. Skin grafting is an essential skill for the reconstructive surgeon to provide durable coverage of a wound with minimal donor site morbidity.
This is a preview of subscription content, log in via an institution to check access.
References
Reverdin JL. Skin grafts – experience derived from the service of Dr Guyon at hospital Necker. Bull Imp Soc Chir Paris. 1869;10:511–5.
McDowell F. The source book of plastic surgery. Baltimore: Lippincott Williams & Wilkins; 1977.
Lawson G. On the transplantation of portions of skin for the closure of large granulating surfaces. Trans Clin Soc Lond. 1871;4:49–53.
Ollier LXEL. Autogenous skin grafts. Bull Acad Med Paris. 1872;1:243–6.
Thiersch C. About the fine anatomical changes in the healing of skin over granulations. Ver Dets Ges Chir Berlin. 1874;3:69–76.
Wolfe JR. A new method of performing plastic operations. BMJ. 1875;2:360–6.
Krause F. The transplantation of large unpedicled skin flaps. Ver Dtsch Ges Chir Berlin. 1893;22:46–52.
Blair VP, Brown JB. The use and uses of large split skin grafts of intermediate thickness. Surg Gynecol Obstet. 1929;49:82–97.
Andrew DR. The Guinea pig club. Aviat Space Environ Med. 1994;65(5):428.
Haubner F, Ohhman E, Pohl F, Strutz J, Gassner HG. Wound healing after radiation therapy: review of the literature. Radiat Oncol. 2012;7(1):162.
Parrett B, Matros E, Pribaz J, Orgill D. Lower extremity trauma: trends in the management of soft-tissue reconstruction of open tibia-fibula fractures. Plast Reconstr Surg. 2006;117(4):1315–22.
Shimizu R, Kishi K. Review article: skin graft. Plast Surg Int. 2012:1–5.
Thorne C. Grabb and Smith’s plastic surgery. 1st ed. Philadelphia: Wolters Kluwer; 2015.
Nahabedian M. Acellular dermal matrices in primary breast reconstruction: principles, concepts, and indications. Plast Reconstr Surg. 2012;130:44S–53S.
Janie JE, O’Neill AC, Ahmad J, et al. Acellular dermal matrices in abdominal wall reconstruction: a systematic review of the current evidence. Plast Reconstr Surg. 2012;130(5 Suppl 2):S183–93.
Shores J, Gabriel A, Gupta S. Skin substitutes and alternatives: A review. Adv Skin Wound Care. 2007;20(9):493–508.
Buchanan P, Kung T, Cederna P. Evidence based medicine: wound closure. Plast Reconstr Surg. 2016;138:257S–70S.
Semer N. Practical plastic surgery for nonsurgeons. 1st ed. Philadelphia: Hanley & Belfus; 2001.
Singh M, Nuutila K, Kruse C, Dermietzel A, Caterson E, Eriksson E. Pixel grafting: an evolution of mincing for transplantation of full-thickness wounds. Plast Reconstr Surg. 2015;137(1):92e–9e.
Hazani R, Whitney R, Wilhelmi B. Optimizing aesthetic results in skin grafting. Am Surg. 2012;78:151–4.
Bibbo C. VERSAJET hydrosurgery technique for the preparation of full thickness skin grafts and the creation of retrograde split thickness skin grafts. J Foot Ankle Surg. 2010;49(4):404–7.
Gupta S. Optimal use of negative pressure wound therapy for skin grafts. Int Wound J. 2012;9:40–7.
Disa J, Halvorsen E, Hidalgo D. Chapter 303: open wound requiring reconstruction. In: Soube WW, editor. ACS surgery: principles and practice. New York: Decker Publishing; 2005.
Brown DL, Buchman SR, Cederna PS. Greenfield’s surgery: scientific principles and practice. 5th ed. New York: Lippincott, Williams & Wilkins; 2010.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Use of a dermatome to take a split-thickness skin graft, with truncation of graft with metzenbaum scissors (MOV 92438 kb)
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Fortier, J.L., Castiglione, C.L., Guo, L. (2018). Skin Grafting. In: Orgill, D. (eds) Interventional Treatment of Wounds. Springer, Cham. https://doi.org/10.1007/978-3-319-66990-8_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-66990-8_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-66989-2
Online ISBN: 978-3-319-66990-8
eBook Packages: MedicineMedicine (R0)