A comparative study of full‐thickness skin grafting with and without subcutaneous fat preservation

Abstract

Skin grafting is an important method of wound repair and reconstruction. Skin grafting can be classified using multiple classification criteria. We often perform full‐thickness skin grafting (FTSG) for small wound areas; however, the traditional FTSG technique frequently causes postoperative scar depression at the donor site, especially in the abdomen. This study aimed to determine whether preserving the subcutaneous fat when performing FTSG can improve donor site prognosis. We reviewed 25 patients who underwent autologous FTSG in the last 3 years. Among them, subcutaneous fat was preserved in 11 patients (experimental group), whereas it was not preserved in 14 patients (control group). Using a 3D camera and the Patient and Observer Scar Assessment Scale (POSAS), we evaluated the donor site postoperatively. According to POSAS, vascularization was significantly more severe in the experimental group. The Antera 3D camera revealed more severe scar depression at the donor site in the control group. The processing time for graft take, subcutaneous fat trimming and donor site closure was less in the experimental group than in the control group. Preserving subcutaneous fat at the donor site improved patient outcomes by reducing donor site depression after FTSG.

Is full‐thickness skin grafting with subcutaneous fat preservation a better solution?

“…by Liu and colleagues. 1 This retrospective case-control study examined 25 patients who underwent autologous full-thickness skin grafting (FTSG) in 3 years. Among them, subcutaneous fat was preserved in 11 patients (cases), whereas it was not preserved in 14 patients (control).…”

“…It is interesting to read the article entitled “A comparative study of full‐thickness skin grafting with and without subcutaneous fat preservation.” by Liu and colleagues. 1 This retrospective case–control study examined 25 patients who underwent autologous full‐thickness skin grafting (FTSG) in 3 years. Among them, subcutaneous fat was preserved in 11 patients (cases), whereas it was not preserved in 14 patients (control).…”

“… 2 , 3 However, there are important risk factors for delayed healing of the donor site, which include smoking, preoperative body mass index, diabetes, peripheral vascular diseases, immunosuppression, calciphylaxis, and connective tissue disorders. 4 , 5 In the report by Liu and colleagues, 1 these important risk factors were not accounted for in the analyses, as this information is lacking, for a valid conclusion. Oftentimes, patients at level 1 major trauma centers have significant comorbidities.…”