Compatibility of Ankle Skin as a Full Thickness Donor Site for Palmar Reconstruction

ABSTRACT

Although full-thickness skin grafts from the groin donor site are widely used to reconstruct a palmar skin defect, there are many aesthetic and functional problems. To solve the problems, we evaluated the compatibility of ankle skin as a full-thickness donor site for palmar reconstruction. In this study, a grafting method using ankle skin harvested from the just distal area of the lateral malleolus was performed in 17 patients to correct the post-graft contracture of the palm grafted from the groin area. Postoperative course was uneventful except 1 case of donor site disruption. Patient satisfaction rate and color difference rate using color chart manual between the grafts from the groin and ankle were assessed during the follow-up period. The parameters involved color matching, texture matching, durability, mobility, hair growth, hypertrophic marginal scar, donor site scar, patient satisfaction rate, and luminosity, yellowness, and redness in color difference. Most parameters were excellent in the graft from the ankle than that of the groin and significant difference in color was found between the 2 grafts(p < 0.05). The normal skin specimens of the palm, ankle, and groin were examined to compare their histological characters. Ten specimens were taken respectively from both sexes in each site. The skin of the palm and that of the ankle was histologically similar, but it is significantly different from the groin skin, especially in thickness(p < 0.05). Therefore, despite size limitation, the ankle should be considered as a useful option in case of palmar resurfacing of the digits and hand.