WORLD JOURNAL OF PLASTIC SURGERY
Thu, Jan 2, 2025
[Archive]
Volume 10, Issue 2 (2021)
WJPS 2021, 10(2): 25-32 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Eskandarlou M, Taghipour M. Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study. WJPS 2021; 10 (2) :25-32
URL: http://wjps.ir/article-1-792-en.html
URL: http://wjps.ir/article-1-792-en.html
1- Department of General Surgery, Faculty of Medicine, Hamadan University of Medical Science, Hamadan, Iran.
Abstract: (2904 Views)
BACKGROUND: Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs and buttocks. Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing and better cosmetics results) this study is trying to compare the outcomes of graft harvesting from scalp and lower limb.
METHODS: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb respectively. The resultant data was analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp).
RESULTS: Of the total 40 patients participating in this study 28 patients (70%) were male and 12 (30%) were female with and mean age of 63.62±09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among the patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal respectively. Most of the defects were deep to Galea zone. The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameter of defect in both groups were statistically meaningful while no such difference between graft diameter was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale.
CONCLUSION: Scalp can safely be used as donor site for skin graft to be used for scalp defects which is associated with better results and lower complication rates compared to other donor sites.
METHODS: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb respectively. The resultant data was analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp).
RESULTS: Of the total 40 patients participating in this study 28 patients (70%) were male and 12 (30%) were female with and mean age of 63.62±09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among the patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal respectively. Most of the defects were deep to Galea zone. The mean diameter of defect was 24.28±45.37 mm for all of the patients. The difference between diameter of defect in both groups were statistically meaningful while no such difference between graft diameter was seen. The graft “Take” was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale and the satisfaction was higher in them per Likert scale.
CONCLUSION: Scalp can safely be used as donor site for skin graft to be used for scalp defects which is associated with better results and lower complication rates compared to other donor sites.
References
1. Yu WY, Salmon P, Thuener J, Bordeaux JS. Mohs Surgery for Advanced Tumors of the Scalp. Dermatol Surg 2019;45: S110-S117.
2. Ellis M, Hwang L, Ford NK, Slavin K. The Role of the Visor Flap in Scalp Reconstruction: A Case Series of 21 Patients. Oper Neurosurg (Hagerstown) 2018;15:651-655.
3. Kim J. Treatment of Scalp Scars. Facial Plast Surg Clin North Am 2017;25:83-88.
4. Desai SC, Sand JP, Sharon JD, Branham G, Nussenbaum B. Scalp reconstruction: an algorithmic approach and systematic review. JAMA Facial Plast Surg 2015;17:56-66.
5. Hafner J, Läuchli S, Bruckert S, Nobbe S, Moehrle M, Löser C. Split skin graft "from scalp to scalp" for repairing large surgical defects. J Dtsch Dermatol Ges 2015;13:937-40.
6. Wollina U, Schönlebe J, Bujok V, Lotti T, Tchernev G, Temelkova I, Vojvodic A. Dermal Pleomorphic Sarcoma of the Scalp - Report of Two Cases. Open Access Maced J Med Sci 2019;7:2982-2984.
7. Mujahid AM, Khalid FA, Ali N, Sajjad Y, Khan H, Tarar MN. Vacuum-assisted Closure in Integration of Skin Graft Over Scalp Wounds: A Randomised Control Trial. J Coll Physicians Surg Pak 2020;30:163-167.
8. Scupham L, Ingle A. Split thickness skin graft in active psoriasis in patient with clear cell variant squamous cell carcinoma. BMJ Case Rep 2019;12. pii: e231295.
9. Nilforoushzadeh MA, Lotfi E, Heidari-Kharaji M. Autologous adipose transplantation an effective method to treat alopecia after trauma: a case report. Clin Cosmet Investig Dermatol 2019;12:647-651.
10. Hilton CMH, Hölmich LR. Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series. World J Plast Surg 2019;8:331-337.
11. Croley JAA, Hirshburg JM, Wagner RF Jr. Clinical Pearl: advantages of the scalp as a split-thickness skin graft donor site. Cutis 2019;103:369-370.
12. Maruyama S. Harvesting Split-thickness Skin from the Scalp Using a Scalpel. Plast Reconstr Surg Glob Open 2019;7: e2206.
13. Alam M, Cooley J, Plotczyk M, Martínez-Martín MS, Izeta A, Paus R, Jimenez F. Distinct Patterns of Hair Graft Survival After Transplantation Into 2 Nonhealing Ulcers: Is Location Everything? Dermatol Surg 2019;45:557-565.
14. Anas Aljasir, Thomas Pierson, Gerd Hoffmann, Henrik Menke. Management of donor site infections in split-thickness skin graft with water-filtered infrared-A (wIRA). GMS Interdiscip Plast Reconstr Surg DGPW 2018;7: Doc03.
15. CI Otene, PB Olaitan, IS Ogbonnaya, RE Nnabuko. Donor Site Morbidity Following Harvest Of Split-Thickness Skin Grafts In South Eastern Nigeria. J West Afr Coll Surg 2011;1: 86-96.
16. Ruka Shimizu and Kazuo Kishi. Skin Graft. Plast Surg Int 2012; 2012: 563493.
17. Yoshitaka Kubota, Nobuyuki Mitsukawa, Kumiko Chuma, Shinsuke Akita, Yoshitaro Sasahara, Naoaki Rikihisa, Kaneshige Satoh. Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting. Burns Trauma 2016;4:9.
18. Saad M. Alrobaiea, Jie Ding, Zengshuan Ma, Edward E. Tredget. A Novel Nude Mouse Model of Hypertrophic Scarring Using Scratched Full Thickness Human Skin Grafts. Adv Wound Care (New Rochelle) 2016;5:299-313.
19. A. Enshaei, N. Masoudi. Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients. Glob J Health Sci 2014;6:98-102.
20. Oganesyan, Gagik, Jarell, Abel D, Srivastava, Monika, Jiang, Shang I. Brian. Efficacy and Complication Rates of Full-Thickness Skin Graft Repair of Lower Extremity Wounds After Mohs Micrographic Surgery. Dermatologic Surgery 2013;39:1334-39.
21. Yolanda Zayakova, Anton Stanev, Hristo Mihailov, Nicolai Pashaliev. Application of Local Axial Flaps to Scalp Reconstruction. Arch Plast Surg 2013;40:564-569.
22. Julien Quilichini, Marc-David Benjoar, Mikael Hivelin, M. Split-Thickness Skin Graft Harvested From the Scalp for the Coverage of Extensive Temple or Forehead Defects in Elderly Patients. Arch Facial Plast Surg 2012;14:137-139.
23. Martin I. Newman, Matthew M. Hanasono, Joseph J. Disa, Peter G. Cordeiro, and Babak J. Mehrara. Scalp Reconstruction: A 15-Year Experience. Annals of Plastic Surgery 2004;52:501-506..
24. Gurdayal Singh Kalra, Pradeep Goil, and Pranay S Chakotiya. Microsurgical reconstruction of major scalp defects following scalp avulsion. Indian J Plast Surg 2013;46:486-492. s
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
