Tag Archives: Skin Graft

General Surgery, Global Surgery, Plastic Surgery, Print Release

PUBLISHED: Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh

Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh
Geoffrey G. Hallock, MD
Sacred Heart Campus, St. Luke’s Hospital

Skin is the largest organ by surface area of the body and is essential to prevent dehydration as the first barrier to infection, permit unrestricted movement, and provide a normal profile and appearance. A skin graft is a paper-thin piece of skin that has no fat or other body tissues attached and has been completely removed from its blood supply. Therefore, a skin graft can be transferred anywhere in the body as long as where placed, the so-called recipient site, does have a sufficient blood supply to nourish the skin until new blood vessels can grow into it within a short timeframe. Otherwise, if that does not occur, the graft will shrivel up and die. The downside even of a successful skin graft is the variable final color and inharmonious appearance of the skin, a tendency to contract possibly causing deformities especially limiting motion across joints, and similar healing issues at a second wound, that is the donor site of the graft itself. Nevertheless, this is a rapidly performed surgical procedure requiring but the simplest of instrumentation for the harvest of that graft that can then permit replacement of extensive skin deficiencies. In this video article, these virtues are displayed as a split-thickness skin graft is used to replace the skin missing following the removal of a large squamous cell skin cancer of the forearm.

General Surgery, Pediatrics, Plastic Surgery, Print Release

PUBLISHED: Split-Thickness Skin Graft for Scar Release, Permanent Pigment Transfer, and Fractional CO2 Laser Therapy

Split-Thickness Skin Graft for Scar Release, Permanent Pigment Transfer, and Fractional CO2 Laser Therapy
Aleia M. Boccardi, DO1; Robert J. Dabek, MD2; Lisa Gfrerer, MD, PhD3; Daniel N. Driscoll, MD, FACS4
1St. John’s Episcopal Hospital
2Massachusetts General Hospital
3Harvard Plastic Surgery Combined Residency Program
4Shriners Hospitals for Children – Boston

Pediatric burns are one of the most common forms of injury affecting children worldwide. Of these, hand involvement occurs in 80–90% of such incidents. With the skin in children already diffusely thinner throughout the body than adults, this provides a particular challenge for areas naturally possessing thinner skin, such as the dorsal hand. There, the cutaneous tissue is the only protection for vital structures in the hand that allow full function, such as extensor tendons, nerves, and vessels. Injury to this area early in life can have a detrimental impact on how the survivor interacts with the physical world, affecting their functional capacity and quality of life.

Here presents a case of burn contractures on the right hand of an 8-year-old boy that will be released using a split-thickness graft, along with a pigment transfer graft for his left knee and fractional CO2 laser therapy over areas of hypertrophic scar tissue on his bilateral upper extremities. The split-thickness graft will greatly decrease the tension built up from the burn contracture, while the fractional CO2 laser procedure can soften the surrounding scar, allowing mild remodeling and increased range of motion.

General Surgery, Pediatrics, Plastic Surgery, Print Release

PUBLISHED: Contracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire Insertion

Contracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire Insertion
Ryan P. Boyle1; Jonah Poster2; Jonathan Friedstat, MD3
1Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine
2Icahn School of Medicine at Mount Sinai
3Shriners Hospitals for Children – Boston

The complications stemming from a poorly-healed burn wound can lead to functional deficits and overall aesthetically unfavorable results leading to psychological distress. Due to the inquisitive nature of infants and toddlers, and their nature to learn the world with their hands, their sensitive regions like the hands become likely targets for burns.

Superficial burns can be managed on an outpatient basis with spontaneous healing expected in 2 or 3 days with minimal scarring. Deep burns, particularly in pediatric populations, need considerable attention to avoid secondary contracture that leads to deformity.

Many treatment options exist, but in sensitive areas like the hands and face, full-thickness skin grafts are favored due to their superior healing and decreased likelihood of secondary contracture. This article aims to guide the surgeon in managing a pediatric burn wound with an arsenal of treatment options with the goal of achieving full mobility and functionality of the hand.

Plastic Surgery, Print Release

PUBLISHED: Integra Scalp Reconstruction: Addressing a Full-Thickness Scalp Defect with Exposed Calvarium Along Vertex in an Elderly Immunocompromised Patient

Integra Scalp Reconstruction: Addressing a Full-Thickness Scalp Defect with Exposed Calvarium Along Vertex in an Elderly Immunocompromised Patient
Cheryl Yu, MD1; Derek Sheen, MD2; Katherine M. Yu, MD1; Alyssa N. Calder, MD1; Christopher J. Kandl, MD1; Thomas Lee, MD, FACS1
1Virginia Commonwealth University Medical Center
2University of Texas Southwestern Medical Center

Reconstruction of full-thickness scalp defects often poses various challenges depending on the complexity and characteristics of the wound as well as independent patient health factors. Despite a range of reconstructive options ranging from primary closure, adjacent tissue transfer, and autografts to free flap reconstruction, there is no universally adopted decision algorithm.

Integra, an acellular matrix composed of crosslinked bovine collagen and glycosaminoglycan covered by a silicone membrane, is widely used for scalp reconstruction and has been shown to produce excellent functional and cosmetic results.

The featured case involves staged scalp reconstruction utilizing the Integra bilayer matrix wound dressing for an elderly immunocompromised patient presenting with two adjacent full-thickness scalp defects resulting in exposed calvarial bone over the vertex. The discussion centers on determining the most optimal scalp reconstructive option and exploring the treatment algorithm used at our institution. Furthermore, application of Integra for calvarial bone coverage will be discussed.

General Surgery, Global Surgery, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh

Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh
Hospital Leonardo Martinez, Honduras

Geoffrey G. Hallock, MD
Plastic Surgery Consultant
Sacred Heart Campus, St. Luke’s Hospital
Allentown, Pennsylvania

In this case, Dr. Hallock performs a right forearm squamous cell carcinoma excision followed by a split-thickness skin graft from the thigh. It was filmed in Honduras on a surgical mission with the World Surgical Foundation.

Global Surgery, Hand Surgery, Orthopedics, Preprint Release

PREPRINT RELEASE: Bilateral Syndactyly Release of Third and Fourth Fingers


Bilateral Syndactyly Release of Third and Fourth Fingers
Hospital Leonardo Martinez, Honduras

Sudhir B. Rao, MD
Big Rapids Orthopaedics

Mark N. Perlmutter, MS, MD, FICS, FAANOS
Carolina Regional Orthopaedics

The patient in this case is a 1-year-old female with complex syndactyly of the right hand and simple syndactyly of the left hand. Here, Dr. Rao and Dr. Perlmutter release both sides, with the right side involving a full-thickness skin graft taken from the patient’s groin crease. This case was filmed during a surgical mission with the World Surgical Foundation in Honduras.

Announcement, General Surgery, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Split-Thickness Skin Graft for Scar Release, Permanent Pigment Transfer, and Fractional CO2 Laser Therapy


Split-Thickness Skin Graft for Scar Release, Permanent Pigment Transfer, and Fractional CO2 Laser Therapy
Shriners Hospitals for Children – Boston

Daniel N. Driscoll, MD, FACS
Division of Plastic, Reconstructive, and Laser Surgery
Shriners Hospitals for Children – Boston

Lisa Gfrerer, MD, PhD
Harvard Plastic Surgery Combined Residency Program

Robert J. Dabek, MD
Research Fellow
Massachusetts General Hospital

This case focuses on the treatment of an 8-year-old male with scars from burn wounds he sustained at the age of 2 that have resulted in areas of scar contracture, stiffness, and hypopigmentation. Watch Dr. Daniel Driscoll perform a scar release, a split-thickness skin graft, a permanent pigment transfer, and fractional CO2 laser resurfacing.