Evaluation of Donor Site Pain After Fractional Autologous Full-Thickness Skin Grafting

Abstract

Background: Despite the development of numerous wound treatment alternatives, 25% to 50% of leg ulcers and >30% of foot ulcers are not fully healed after 6 months of treatment. Autologous skin grafting is a time-tested therapy for these wounds; however, the creation of a new wound in the donor area yields a considerable limitation to this procedure.Innovation: Fractional autologous full-thickness skin grafting (FFTSG) is a technique wherein multiple small full-thickness skin grafts (FTSGs) are harvested with possibly minor donor-site comorbidities. The first device used to harvest FFTSG (ART™ system, Medline, Northfield, IL) is a device capable of harvesting >300 small FTSGs and transferring them to a target wound.Objective: To better evaluate patients' clinical experience, we sought to evaluate pain at the donor site associated with this procedure.Approach: Pain was assessed with numeric visual analog pain scales at days 1, 2, 4, and 7. Nine subjects underwent this procedure with only six of them reporting any level of pain on day 1, and none disclosing pain after day 2.Conclusion: In this study, we evidenced that this device manages to harvest FTSGs with minimal associated pain. Future research will need to evaluate other aspects of the procedure as well as long-term outcomes at the donor and recipient areas.

Absence of donor‐site pathergy following fractional autologous full‐thickness skin grafting in pyoderma gangrenosum

“…The columns may re‐align themselves with proper orientation during the healing process or provide cytokines that stimulate healing as animal studies and early human experience suggest enhanced healing . Although this technique implies deeper collection of tissue and the pathergy risk may be even more worrisome than in STSGs; in a previous study, we found minimal pain and morbidity at the donor site …”

“…Another option is, FFTSG, a technique in which multiple full‐thickness skin grafts (FTSGs), each 500 μm wide and up to 3·25 mm deep, are harvested minimizing donor‐site comorbidities . The device used harvests 300 columns of FTSGs and transfers them to the target ulcer.…”

Point‐of‐care detection of neutrophils in live skin microsamples using chemiluminescence

“…In normal skin, the wounds epithelialize or create a barrier closing the wound within a day and the scab covering the wounds falls off by day three. The extraction procedure is less painful because of the cutting geometry and motion of the needle: a quick forward motion as opposed to a rotational one . The extraction and healing characteristics of this microsampling technique could lower the time and number of biopsies thresholds for sampling the skin.…”

A Concise Review on Tissue Engineered Artificial Skin Grafts for Chronic Wound Treatment: Can We Reconstruct Functional Skin Tissue In Vitro?

“…Because of the low risk of immune rejection, autografts are most often used for skin regeneration. Taking into account the anatomical structure of autologous skin grafts, they are classified as epidermal skin grafts (ESGs), split-thickness skin grafts (STSGs), and full-thickness skin grafts (FTSGs) [9,10].…”