Full-thickness Skin Microcolumns Implanted into a Dermal Regeneration Template: A Novel Method for Donor-free Skin Replacement Therapy

摘要

BACKGROUND: Split-thickness skin graft is the current standard in the treatment of large full-thickness skin defects. The donor site resulting from tangential skin harvest is well recognized as painful and unsightly, even after it has healed. Several efforts have been made in the past to address this problem by limiting the amount of skin harvested while significantly expanding the skin elements (ReCell, Meek). These efforts suffer from short comings such as graft fragility and failure to achieve adequate closure in a reasonable period of time. Full-thickness skin columns are a novel concept in skin harvest with little to no donor site when the diameter of the columns falls below a certain threshold. There is also a theoretical advantage that the columns harvested contain elements of full-thickness skin including sweat glands and hair follicles. Here, we present 2 cases where full-thickness skin columns were harvested and implanted into a bilayer dermal regenerative template (Integra) to achieve durable single-stage skin replacement.