Optimal selection of donor site for full-thickness skin graft in pediatric palmar hand skin defect
10.3760/cma.j.cn114453-20200229-00088
- VernacularTitle:儿童手部掌侧皮肤缺损全厚皮片移植术供区优化选择
- Author:
Xiaoyan QIN
1
;
Jun XIAO
;
Tianwu LI
;
Lin QIU
;
Yuexian FU
;
Xiaofei TIAN
Author Information
1. 重庆医科大学附属儿童医院烧伤整形外科 儿童发育疾病研究教育部重点实验室 国家儿童健康与疾病临床医学研究中心 儿童发育重大疾病国家国际科技合作基地 儿科学重庆市重点实验室，重庆 400014
- Keywords:
Palmar;
Full-thickness skin graft;
Donor site;
Skin transplantation;
Child
- From:
Chinese Journal of Plastic Surgery
2022;38(5):549-557
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims at exploring the groin area, the ulnar side of the wrist, and the medial plantar side as a more optimal donor area for repairing children’s hand volar skin defects.Methods:From December 2017 to December 2018, clinical data of children with palmar skin defects of hands who underwent full-thickness skin grafting in the Department of Burn and Plastic Surgery, Children’s Hospital Affiliated to Chongqing Medical University, were retrospectively analyzed. All skin grafts survived utterly. According to the donor site of full-thickness skin graft, the children were divided into three groups: the groin, ulnar wrist, and medial plantar skin donor group. The PANTONE skin tone guide measured the color difference between the full-thickness skin graft and the surrounding skin. The postoperative scars of the recipient and donor areas were scored by the Patient and Observer Scar Assessment Scale. Meanwhile, the postoperative effect and parents’ satisfaction with recipient and donor areas were evaluated. Kruskal Wallis rank-sum test and Mann Whitney U test were used for measurement data. Fisher’s exact test was used for counting data. A P-value <0.05 was considered significant. Results:A total of 68 children were enrolled, including 44 males and 24 females. The mean age was (3.19 ± 2.74) years (ranging from 6 months to 14 years). Among them, 37 children’s palmar skin defects were reconstructed by full-thickness skin grafts from the inguinal region, 19 from the ulnar side of the wrist, and 12 from the medial side of the plantar. The final follow-up time was from 7 months to 18 months, with an average of (14.07±2.94) months. There were significant differences among the three groups in the pigmentation of skin grafts and parents’ satisfaction ( P<0.01). The color difference of medial plantar skin donor group and ulnar wrist skin donor group was small, and the groin skin donor group had the most obvious color difference of skin graft. The satisfaction of parents in the medial plantar skin donor group was the best, followed by the ulnar wrist skin donor group, and the groin skin donor group had the worst satisfaction of parents. There was no significant difference in scar evaluation in recipient and donor areas among the three groups( P>0.05). Among the parents’ satisfaction ratings in the receiving area of the three groups, the medial plantar group had the highest proportion of excellent, followed by the ulnar wrist group and the groin group. There were significant differences among the three groups( P<0.01). Conclusions:The full-thickness skin graft harvested from the medial plantar and ulnar side of the wrist are better choices for small or medium-sized palmar skin defects in children than the inguinal area with superior aesthetics. The medial plantar area is recommended as a donor site for the palmer skin defects in hands, choosing the ulnar aspect of the wrist is more appropriate for the defects in the lateral fingers.
