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The Clinical Evaluation of a Novel Device for the Creation of Micrografts for the Treatment of Chronic Wounds
Mariam Al-Hamad Daubs
*, Thomas Davenport
Plastic and Reconstructive Surgery , Long Island Plastic Surgery Group/Nassau University Medical Center/Stony Brook University, Manhasset, NY
IntroductionSkin grafting is a common treatment for full thickness defects. Full thickness skin grafts (FTSG) have the benefit of being a resilient and functional graft but can have healing challenges in less optimal skin graft beds. (1) By meshing FTSGs into thinner and smaller micro grafts, these grafts allow drainage, have improved imbibition, and allow for better contact with topical antimicrobial agents. (2,8,9) We describe, in a pilot study, a novel FTSG meshing device that creates high viability full thickness micrografts. We present a series of patients where processed full thickness skin micrografts were used to graft and heal chronic wounds.
MethodsTen patients with non-healing wounds of greater than four weeks duration and standard of care treatment with minimal change in size were grafted with minced full thickness grafts (250-750 microns) processed using a novel skin morcellation device. Post surgically, graft take, healing time and donor site morbidity were evaluated. An additional patient that did not meet the inclusion criteria due to active pyoderma vasculitis was also grafted using tissue mill after the study period using the same parameters.
Results Graft take was 95-100% in all cases with healing time ranging from 2.5 to 9 weeks. All donor sites were closed primarily and healed within 2 weeks without complication. Patients were followed for 12 weeks with healing evaluated. The additional pyoderma patient also healed all wounds with no donor site complication in 63 days.
ConclusionWounds grafted with full thickness skin meshed in a novel skin morcellation device into micrografts can heal with 95-100 % graft take over 2.5 to 9 weeks. All donor sites closed primarily healed within 2 weeks. This technique of using processed full thickness micrografts has benefits over split grafting with the convenience of having no open donor sites and minimal equipment needs with comparable success rates. A closed donor site is even more important in patient with pyoderma vasculitis where a split thickness donor site may develop into an additional healing challenge.
Figure 1.
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