Maruyama Seiichi
Hills Aesthetic and Cosmetic Clinic, Fujisawa, Kanagawa Prefecture, Japan.
Plast Reconstr Surg Glob Open. 2019 May 3;7(5):e2206. doi: 10.1097/GOX.0000000000002206. eCollection 2019 May.
Split-thickness skin grafts (STSGs) from the scalp may be an attractive option for patients who do not want scars on their limbs or trunk. However, not all institutions have the equipment typically used to perform STSGs.
Between January 2015 and June 2017, STSGs were harvested with a No. 15 blade under local anesthesia from the scalps of 4 patients and grafted on small skin defects from facial trauma, a tattoo, and scarring, and on a large defect from burns. Epithelialization of the donor sites and graft take, secondary contraction, and color and texture match of the recipient sites were observed. Thickness of the harvested skin was confirmed by histopathologic examination.
Mean patient age was 39.8 years; 2 patients were male. Epithelialization of the donor sites took a mean of 8.75 days. No hypertrophic scarring or alopecia was observed. Good graft take and relatively good color and texture match of the recipient site were achieved. Mild secondary contraction was noted in 2 cases. Histopathologic examination showed no damage to the hair follicles. The thickness of the harvested skin varied from 0.3 to 0.7 mm.
Using the scalpel technique, surgeons can perform STSGs with only several blades, minimizing surgical costs. The hair follicles remain intact because the thickness of the graft skin is <1 mm. Epithelialization of the donor site is quick, and there is no visible wound on the limb or trunk. It is especially useful to cover small defects.
对于不希望肢体或躯干留下疤痕的患者而言，取自头皮的中厚皮片移植可能是一个颇具吸引力的选择。然而，并非所有机构都具备进行中厚皮片移植的常用设备。
2015年1月至2017年6月期间，在局部麻醉下，用15号刀片从4例患者的头皮获取中厚皮片，并移植到面部创伤、纹身及瘢痕形成所致的小面积皮肤缺损处，以及烧伤所致的大面积缺损处。观察供皮区上皮化、植皮成活情况、继发性收缩以及受皮区的颜色和质地匹配情况。通过组织病理学检查确定所取皮肤的厚度。
患者平均年龄为39.8岁；2例为男性。供皮区上皮化平均用时8.75天。未观察到肥厚性瘢痕或脱发。植皮成活良好，受皮区颜色和质地匹配相对较好。2例出现轻度继发性收缩。组织病理学检查显示毛囊未受损。所取皮肤厚度在0.3至0.7毫米之间。
采用手术刀技术，外科医生仅用几把刀片就能进行中厚皮片移植，从而将手术成本降至最低。由于移植皮肤厚度<1毫米，毛囊得以保持完整。供皮区上皮化迅速，肢体或躯干无可见伤口。对于覆盖小面积缺损尤为有用。
