Journal
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN
Volume 1, Issue 6, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GOX.0b013e3182a85a36
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Funding
- Defense Advanced Research Projects Agency (DARPA) [W911NF-11-1-0122, W911NF-12-1-0086]
- Army Research Office (ARO) [W911NF-11-1-0122, W911NF-12-1-0086]
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Background: Conventional autologous skin grafts are associated with significant donor-site morbidity. This study was conducted to determine feasibility, safety, and efficacy of a new strategy for skin grafting based on harvesting small columns of full-thickness skin with minimal donor-site morbidity. Methods: The swine model was used for this study. Hundreds of full-thickness columns of skin tissue (similar to 700 mu m diameter) were harvested using a custommade harvesting device, and then applied directly to excisional skin wounds. Healing in donor and graft sites was evaluated over 3 months by digital photographic measurement of wound size and blinded, computer-aided evaluation of histological features and compared with control wounds that healed by secondary intention or with conventional split-thickness skin grafts (STSG). Results: After harvesting hundreds of skin columns, the donor sites healed rapidly without scarring. These sites reepithelialized within days and were grossly and histologically indistinguishable from normal skin within 7 weeks. By contrast, STSG donor sites required 2 weeks for reepithelialization and retained scar-like characteristics in epidermal and dermal architecture throughout the experiment. Wounds grafted with skin columns resulted in accelerated reepithelialization compared with ungrafted wounds while avoiding the fish-net patterning caused by STSG. Conclusion: Full-thickness columns of skin can be harvested in large quantities with negligible long-term donor-site morbidity, and these columns can be applied directly to skin wounds to enhance wound healing.
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