Immediate regraft of the remnant skin on the donor site in split-thickness skin grafting

BACKGROUND: Skin defects of head and neck need reconstruction using various local flaps. In some cases, surgeons should consider skin graft for large skin defect. It is important to heal skin graft and donor sites. The authors investigated wound healing mechanisms at the donor sites with split-thick-ness skin graft (STSG). In this study, the authors compared two types of immediate regraft including sheets and islands for the donor site after facial skin graft using remnant skin. METHODS: The author reviewed 10 patients who underwent STSG, from March 2015 to May 2017, for skin defects in the craniofacial area. The donor site was immediately covered with the two types using remnant skin after harvesting skin onto the recipient site. Depending on the size of the remnant skin, we conducted regraft with the single sheet (n= 5) and island types (n= 5). RESULTS: On postoperative day 1 and 3 months, the scar formation was evaluated using the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS). Total POSAS and VSS scores for the island type were lower than in single sheet group after 3 months postoperatively. There was significant difference in specific categories of POSAS and VSS. CONCLUSION: This study showed a reduction in scar formation following immediate regrafting of the remnant skin at the donor site after STSG surgery. Particularly, the island type is useful for clinical application to facilitate healing of donor sites with STSG.

Effects of sevoflurane and propofol on wound healing in rats: comparison of blood flow and wound size / 대한마취과학회지

BACKGROUND: As the wound healing is a multi-factorial process, the anesthetic agent and the duration of its exposure may influence the healing process after surgery. This study investigated the effect of anesthetic agents and duration of its exposure on the wound healing process after operation. METHODS: Total 32 rats weighing 200-300 g were randomly allocated to one of eight groups according to the exposure time (1, 2, 4, 8 hours) of sevoflurane or propofol (n = 4 each). After wounding under the each anesthetic, anesthesia was maintained for 1, 2, 4 and 8 hours in each group. We compared the skin blood flow around the wound and the wound size at baseline, 3 days, and 7 days postoperatively. RESULTS: In sevoflurane group, short exposure group (1, 2 hours) showed higher wound blood flow than long exposure (4, 8 hours) at 3 days after wounding (P < 0.05), but not at 7 days after wounding. For the wound size, there was no difference at 3 days after wounding in sevoflurane group, but 8 hours exposure group had the largest wound at 7 days after wounding. In propofol group, wound blood flow showed no difference at 3 days after wounding, but that of 4, 8 hours exposure group was higher than 2 hours exposure group at 7 days after wounding. There was no difference in wound size in propofol group. CONCLUSIONS: This study implicates that sevoflurane might influence the wound healing process more prominently than propofol according to the duration of exposure time.