First Aid for Skin Tears by Mini Patch Grafting from the Flap Edge.

BACKGROUND: Traumatic skin tears often occur in patients with dystrophic skin. Closing them with adhesive skin closures is useful for patients with a healthy flap, but occasionally fails to cover the entire defect. We describe a simple technique to perform mini patch grafting on the remaining raw surface without damaging healthy skin. DISCUSSION: The skin flap is spread out and fixed with adhesive skin strips to minimize defects first. Small pieces of skin are obtained by trimming the edges of the skin flap with curved tip scissors. They are placed on the defect with free spaces of 3 to 5 mm between each of the grafts. Then the whole wound is covered with a dressing and gauze pads. Healing of the ulcer could be markedly promoted with little enlargement of the skin defect. CONCLUSIONS: Small pieces of skin trimmed out from the edge of skin flap can be used as a mini patch graft that remarkably enhances healing of remaining open surface.

Effects of physical and chemical treatments upon biophysical properties and micro-relief of human skin.

The aim of the present study was to determine the attendant effects of physical (tape-stripping) and chemical (three commercial hydrating formulations) treatments upon biophysical and micro-relief properties of human skin. In the first set of experiment, the effects of tape-stripping onto human stratum corneum (SC) biophysical and micro-relief properties were assessed in nine volunteers. Transepidermal water loss (TEWL), skin hydration and micro-relief parameters (including total length of the lines in mm per mm(2); total surface in %; roughness of the skin measured in gray level (Ra); maximum profile valley (Rv) depth; maximum profile peak height (Rp); maximum height (Rt), peak density (Pc) and coefficient of anisotropy) were determined by using SkinEvidence Pro after subsequent tape-stripping of SC. The relevance of roughness determination as gray level by SkinEvidence Pro was confirmed by using surface roughness standards. In the second set of experiment, the effectiveness of three commercial hydrating formulations onto human SC biophysical parameters and micro-relief properties were assessed in six volunteers. TEWL, hydration and micro-relief parameters were assessed onto pre-treated acetone skin and then treated by three commercial hydrating formulations after 2, 4 and 6 h skin exposure. A linear relation between hydration and cutaneous parameters (total length of the lines, Ra and Rp) as function of SC removed was shown. Skin barrier properties evaluated by TEWL measurements, were not modified by topical formulations. However, skin treated by topical formulations showed slightly higher hydration than the one determined in control group, while micro-relief parameters were not modified. In this study was showed that biophysical and micro-relief parameters were closely related in tape-stripping experiment. Efficiency of topical formulations was suggested upon skin hydration but not onto skin micro-relief and barrier function recovering. From both experiments, it appears that different mechanisms relating to skin hydration and potential modification of cutaneous micro-relief were suggested.