A retrospective study of thick split-thickness plantar skin grafts to resurface the palm.

Both the function and appearance of thick split-thickness plantar skin grafts to resurface palmar skin defects are examined in this retrospective study. If defects in the hand are covered by grafts from hair-bearing donor sites, these grafts will show increased pigmentation and contrast clearly with the surrounding skin, particularly in the case of patients with heavy skin pigmentation. To avoid this pigmentation, we have used the thick split-thickness skin grafts taken from the plantar region of the foot. The most important aspect of the method is the removal of split-thickness skin with a thick dermal layer. Since 1975, we have used this method in 64 patients and conducted follow-ups on 41 of them. The results of follow-ups indicate that this method is quite successful and useful, especially in patients with dark skin. In general, there was no excessive pigmentation of the grafted skin; color and texture of grafted skin matched the surrounding skin; function recovery is good owing to similar skin structure; thick split-thickness skin with a thick dermal layer prevents contracture of grafted skin; grafted skin withstands trauma; donor site need not be grafted; and the scar at the donor sites is hidden and produced no morbidity. It must be noted, however, that one-third of all patients were lost to follow-up, and the results in these patients are not known.