The Dermisgraft Epithelialization and Late Scar Healing

Background: Donor site morbidity is a major concern such as wound healing disturbances, hypertrophic scarring and hypo-/hyperpigmentation. The dermal graft technique is an alternative to the standard split-thickness skin graft (STSG) technique to minimize donor site morbidity. Immediate cover of the donor site after harvest leaving a non-exposed wound is a big advantage. The aim of the study was to compare the functional and aesthetic outcome between two treatment methods (dermal graft with STSG).

Methods: From February 2017 to December 2020, 21 patients received a dermis graft and a regular split-thickness skin graft in a prospective randomized study design. The recipient and the donor site were compared separately regarding healing time, scarring and patient subjective satisfaction. All sites (both donor and recipient) were analyzed histologically regarding remodeling and scar formation.

Inclusion criteria

• Thermal & chemical burns < 30 % TBSA
• Males & females between 18-80 years old
• At least one coherent full thickness wound measuring 15 x 7.5 cm
• A minimal of 15 x 7.5 cm coherent undamaged skin located at frontal or lateral side of one of the thighs for graft harvest.

Exclusion criteria

• Patients with severe cutaneous trauma at the same site as the burn injury
• Previous burns at the treatment site
• Severe cognitive dysfunction or psychiatric disorder
• Chronic skin disorder
• Chronic use of systemic or local corticosteroid
• Chronic use of anticoagulants or platelets
• Autoimmune disease
• Active hepatitis
• Full thickness burns of head, genitalia, axilla or upper third of medial upper arm