Adjacent-tissue skin grafts for reconstruction.

Abstract

Large defects not easily repaired with local flaps and defects near anatomic free margins or crossing anatomic units present unique challenges for reconstruction. Cosmetic results of full-thickness skin grafts may appear unsatisfactory owing to differences in color, texture, and thickness between donor and recipient sites. The objective was to describe a skin-graft reconstructive method that better approximates skin characteristics between donor and recipient sites while following other criteria to improve the final aesthetic and functional result. Careful evaluation of the tissue surrounding a surgical defect determines tissue laxity available for skin grafting and whether the defect crosses anatomic units or may distort anatomic free margins or landmarks. Through partial closure of the large surgical defect, preferably within cosmetic units, a tricone is created large enough to graft the remaining wound. Creating smaller wounds within cosmetic units or subunits, there is less chance of distortion of nearby anatomic free margins or landmarks. Skin grafting is accomplished with tissue of similar color, texture, and thickness Adjacent-tissue skin grafts provide a suitable reconstruction option for surgical defects too large for simpler repair or defects crossing cosmetic units or near free margins. This procedure permits repair with a full-thickness skin graft of more similar skin characteristics to the recipient site.