"Shift to right flypaper technique" a refined method for postage stamp autografting preparation.

"Lack of donor skin" is a challenge condition for autografting in the treatment of extensive burns. The modified Meek technique seems to be a practical solution for this problem. However, the equipment and consumed materials for the modified Meek technique are expensive which limits routine use. Designing a less expensive, efficient and easy to apply expansion method may improve burn care quality and shorten hospital stay period. Our previous study reported the "flypaper technique" for preparation of postage stamp autografting. The time for confluence of the burned wound depends on the size of the skin islands and expansion ratio. In clinical practice, 5mm skin squares is the preferred size of the skin islands; however, the positioning procedure can be modified to improve the wound healing process. According to the chessboard diagram, the "shift to right" positioning technique shortens the 10% biggest distance in six times expansion diagrams and 20% biggest distance in nine times expansion diagrams. By using a quick cutting plate, chessboard tray and petrolatum gauze, the skin islands can be uniformly located and correctly oriented on the gauze. This method allows a true expansion ratio up to nine times. In comparison with the modified Meek technique, this method also offers rapid wound reepithilization but with lower cost. However, the burn scar needs further rehabilitation and compression therapy to improve the functional and cosmetic result. This "shift to right flypaper technique" is worthy of consideration in dealing with extensive burns.