Skin: punch grafting
Synonym(s): Pinch grafting; Seed grafting; Strip grafting
Introduction
- These grafts are used for reconstruction of full-thickness skin deficits, often involving the distal limb.
- They are designed to 'seed' a granulation bed with multiple epithelial islands to rapidly re-epithelialize a wound surface.
Uses
- Skin deficits on an uneven or angular surface, unsuitable for sheet grafts.
- Less than optimal wound conditions at the recipient site, which may compromise a sheet graft.
- Best used on smaller wounds located in areas not subjected to wear and tear.
Advantages
- Relatively easy technique; no special equipment required.
- Less rigorous preparation required compared to sheet grafting.
- No need for reconstruction of donor areas.
- More forgiving - loss of some seeds can be readily replaced with new ones.
- Can be performed quickly with local Local anesthesia: overview or general anethesia General anesthesia: overview.
Disadvantages
- Cosmetic result, though better than conservative techniques, is not as good as sheet grafting: inter-graft areas heal by epithelial scarring with lack of hair growth.
- Bleeding recipient sites can dislodge the small unanchored grafts.
- Since the technique is used to promote rapid epithelialization, these grafts should not be used over areas prone to mechanical stress. Epithelialized areas are not as durable as normal full-thickness skin.
Alternative techniques
- Sheet grafts, meshed or non-meshed, for non-angular immobile surfaces.
- Skin flaps (advancement, transposition, rotational and axial pattern types) may be appropriate for certain wounds. These are more cosmetic and durable.
Time required
Preparation
- Depends on size of wound and its complexity: 10-20 min.
Procedure
- Depends on size of wound and its complexity: 20-60 min.
Decision taking
Criteria for choosing test
- For optimal graft take a healthy granulating recipient site that has been well-managed before the procedure should be present.
- The recipient area must be able to be immobilized and bandaged.
Requirements
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Preparation
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Technique
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Aftercare
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Outcomes
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
Other sources of information
- How to perform strip skin grafts, Part 1. dvm360: www.youtube.com/watch?v=f0kc2AFfR0E.
- How to perform strip skin grafts, Part 2. dvm360: www.youtube.com/watch?v=ounDT2xFcAQ.
- Pavletic M M (1999) Atlas of small animal reconstructive surgery. Philadelphia: J B Lippincott.