Modified butter knife as a good transporter of epidermal graft

Abstract

Blister transport is an epidermal graft procedure, and it can result in failure as a result of various factors, including tearing or flipping of the epidermal graft.1Albert S. Shenoi S.D. Acetate sheets in the transfer of epidermal grafts in vitiligo.J Am Acad Dermatol. 2001; 44: 719-720Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Therefore, researchers have proposed various techniques to address such challenges.2Laxmisha C. Thappa D.M. JAAD Online: Surgical pearl: gloved finger as a transport platform for epidermal graft of suction blister.J Am Acad Dermatol. 2007; 57: S118-S119Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar In this letter, we present an epidermal graft technique that uses a modified butter knife to overcome these transport problems. We manipulated the tip of an ordinary butter knife with the tip sloping down gently toward its end (Fig 1, A). To use this modified butter knife, we cut the suction cup-induced blister roof, hold the margin of the blister, and then place it on the butter knife with the dermal side facing down. The next step involves straightening the graft evenly to its full size on the modified butter knife and fixing a part of the graft margin on a certain point of the recipient site using forceps (Fig 1, B). Finally, the butter knife is moved backwards, and the graft slides gently and settles down at the recipient site, just like a flat sheet. This epidermal graft procedure using a modified butter knife results in a good cosmetic outcome (Fig 2).Fig 2Successful treatment of the epidermal graft in vitiligo using the modified butter knife.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The epidermal graft can ‘slide’ in its spread form from the tip of the modified butter knife, and thus it has less possibility of rolling up, flipping, or clinging. In conclusion, the modified butter knife can be a useful tool to easily and accurately transport and settle down an epidermal graft in the recipient site.