Pinch Grafts for Cutaneous Ulcers

Techniques of Split‐Thickness Skin Grafting for Lower Extremity Ulcerations

“…Pinch grafts can also be obtained utilizing a skin hook, 2 forceps 3 (Figure 1B), the tip of a needle, 4 or suction 5 to elevate the skin. The skin can then be shaved with either a scalpel or a double‐edged razor blade 6 . Another method we often employ is to create a uniform size graft with a 4‐mm punch biopsy instrument (Figure 2) and to shave a thin horizontal slice of this graft to transplant onto the ulcer bed (Figure 3).…”

The Technique and Current Status of Pinch Grafting

“…While pinch grafting has been performed on an outpatient basis, 8 most of the reports on pinch grafting have only been performed on inpatients 6,9 . This permits the patient to receive aggressive treatment preoperatively with bed rest, elevation of the affected extremity, and diligent debridement of the ulcer bed.…”

“…Unlike full‐thickness skin grafts that are harvested from areas that would yield the best color and textural match with the tissue surrounding the recipient site, the anatomic location for pinch grafting donor sites appears to be unimportant to the functional outcome or to graft survival. Since these very thin grafts do not typically provide a good cosmetic match with the surrounding skin, 6 but rather are used to provide a functional result, the donor site could conceivably be any part of the surface anatomy.…”

“…1) without epineph‐rine 9 . Then, using a bowed double‐edged razor 6 blade or a #11 scalpel blade 9 on a scalpel handle, very thin 1‐ to 1.5‐cm round or oval grafts of approximately 1 mm in thickness are shaved (Fig. 2) from the surface of each wheal using a back‐and‐forth sawing motion.…”

“…The chief disadvantage of this technique is the cosmetic appearance which typically results in the creation of a cobblestone‐like, irregular surface 6 . This technique may also be somewhat limited in the size of wounds that can be treated because of the time required to perform this procedure for large wounds.…”