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Plast Reconstr Surg Glob Open. 2017 May 23;5(5):e1339. doi: 10.1097/GOX.0000000000001339. eCollection 2017 May.

Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing.

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1
Department of Plastic Surgery, Kaiser Permanente, Denver, Colo.; Division of Plastic Surgery, Sacred Heart Hospital, Allentown, Pa.; and Department of Mathematics, Physics, and Statistics, Messiah College, Gratham, Pa.

Abstract

BACKGROUND:

Delayed or even lack of healing of a split-thickness skin graft (STSG) donor site is a potential problem with elderly patients or those with poor wound healing capabilities. A proactive solution that may minimize this risk is to regraft that donor site using otherwise discarded skin graft remnants.

METHODS:

A prospective, nonrandomized, consecutive study was designed to compare the time to healing of the commonly used anterior thigh STSG donor site in patients who had routine dressings (n = 113) versus those with comorbidities known to adversely affect wound healing and had planned regrafting (n = 204). Those comorbidities included age (≥65 years), diabetes mellitus, peripheral vascular disease, chronic renal disease, and chronic steroid use.

RESULTS:

The average number of comorbidities in the regrafted subgroup versus those not regrafted was 1.41 and 0.31, respectively. This was considered to be a significant difference (P < 0.0001) confirming the validity in predicting patients at risk for adverse donor-site healing that would benefit by regrafting. The mean time required for donor-site reepithelialization of those regrafted was 17.2 days compared with 17.8 days for those not regrafted (P = 0.2395), which was not significantly different.

CONCLUSIONS:

Regrafting the STSG donor site of patients with known comorbidities, that is, those expected to have delayed healing in general, had a mean time to reepithelialization comparable with conventionally treated individuals. This was considered a direct consequence of recycling rather than discarding any excess skin graft materials when so indicated and can be a proactive solution to a potentially cumbersome dilemma.

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