Busch Lukas Fabian, Alawi Seyed Arash
World J Plast Surg. 2020 Sep;9(3):259-266. doi: 10.29252/wjps.9.3.259.
Grafting split-thickness (STSGs) and full-thickness skin grafts (FTSGs) are common techniques to replace missing skin and to restore the skin barrier in burn, trauma and remaining skin defects after tumor resections. The defect coverage with skin grafts offer many advantages, but also disadvantages such as donor site morbidity like possible sensory disturbances, scarring, risk of infection, contour changes and pigment disorders. We aimed to assess the preferred distribution of donor site for STSGs and FTSGs in patient's skin grafting for plastic-surgical defect coverage.
Patients and their accompany persons referred to the Department of Plastic Surgery were interviewed for defect coverage with STSGs or FTSGs, the preference in donor site was investigated and the detailed advantages and disadvantages were clarified.
We evaluated 85 participants (male=43, female=42) with a median age of 42 years (mean=46 years). The definition of the donor site (n=188 markings) was mainly based on the physicians recommendation (32.98%), mobility (23.40%), aesthetic results (22.34%) and pain (21.28%). Feared complications (n=152) were mainly wound healing disorders (32.24%), circulation disorders (28.29%), scars (20.39%) and bleeding risks (19.08%) Among all participants, 79 split-skin graft preferences were specified, while 32% favored the scalp as a donor site, as well as 29% the frontal part of the left thigh and 10% the frontal part of the right thigh.
There were preferred anatomical donor sites for skin grafting. Nevertheless, in conscious patients, the donor site has to be selected in a consent talk and joint approval, preoperatively. The options of taking STSGs from the occipital region with all its advantages should be discussed intensively as it is an attractive graft donor site.
移植中厚皮片(STSGs)和全厚皮片(FTSGs)是替代缺失皮肤和恢复烧伤、创伤及肿瘤切除后剩余皮肤缺损处皮肤屏障的常用技术。用皮片覆盖缺损有诸多优点,但也存在缺点,如供区并发症,像可能出现感觉障碍、瘢痕形成、感染风险、外形改变和色素紊乱等。我们旨在评估在整形外科皮肤移植覆盖缺损时,STSGs和FTSGs供区的首选分布情况。
对转诊至整形外科的患者及其陪同人员就使用STSGs或FTSGs覆盖缺损情况进行访谈,调查其对供区的偏好,并阐明详细的优缺点。
我们评估了85名参与者(男性43名,女性42名),中位年龄42岁(平均46岁)。供区的确定(共188处标记)主要基于医生的建议(32.98%)、活动度(23.40%)、美学效果(22.34%)和疼痛情况(21.28%)。令人担忧的并发症(共152例)主要是伤口愈合障碍(32.24%)、循环障碍(28.29%)、瘢痕(20.39%)和出血风险(19.08%)。在所有参与者中,明确了79例对分层皮片的偏好,其中32%倾向选择头皮作为供区,29%倾向左大腿前部,10%倾向右大腿前部。
皮肤移植存在首选的解剖学供区。然而,对于意识清醒的患者,术前必须在知情谈话并取得共同认可后选择供区。应深入讨论从枕部获取STSGs的所有优点,因为它是一个有吸引力的皮片供区。