Minced skin grafting for promoting epithelialization of the donor site after split-thickness skin grafting

It is important to minimize time to healing in the donor site after split-thickness skin grafting (STSG). It has been shown that minced skin grafting improves the appearance of the STSG donor site. The objective of this study was to investigate whether mincing the leftover harvested skin and grafting it back onto the donor site during minced grafting (MG) reduces healing time of the donor site. Normal healing time of the donor site after STSG is 10-20 days; therefore, healing time more than a month is abnormal. Out of the 96 patients (MG: controls =48:48) initially selected for this study, 7 patients (1 in the MG group and 6 in the control group) with abnormal wound healing (healing time >1 month) were excluded because their healing times were too long (from 1.5 to 6 months). All donor sites were on the lateral thigh. A part of the skin was minced and uniformly spread on the entire surface of the donor site. A calcium alginate dressing was applied and covered with a protective gauze dressing. Patients in the control group were treated identically, except that MG was not performed. MG of the STSG donor site reduced the average time to healing by approximately 4days (9.1 vs. 13.2). This effect was independent from the size of the donor site and MG/STSG mass ratio. This procedure, which makes use of skin leftovers after skin grafting, should be perforined prior to applying wound covering material as a means of reducing time to healing and level of patient's discomfort. (C) 2016 Elsevier Ltd and ISBI. All rights reserved.