Surgical Pearl: Gloved finger as a transport platform for epidermal graft of suction blister

Abstract

Epidermal grafting using the tops of suction blisters is one of the surgical repigmenting modalities in vitiligo. The procedure consists of raising blisters over the donor area through a suction cup. Once the bulla is formed, the roof is removed with a pair of curved iris scissors. This graft is then transferred to the dermabraded recipient donor vitiliginous area. Various techniques for transporting the epidermal graft have been used. These include the use of fine gauze, 1 Tang W.Y. De Han J. Lu N.Z. Chan L.Y. Lo K.K. Surgical pearl: fine gauze is a useful carrier for epidermal graft in the treatment of vitiligo by means of the suction blister method. J Am Acad Dermatol. 1999; 40: 247-249 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar microscopic slide, 2 Falabella R. Epidermal grafting: an original technique and its application in achromic and granulating areas. Arch Dermatol. 1971; 104: 592-600 Crossref PubMed Scopus (136) Google Scholar spatula, 3 Koga M. Epidermal grafting using the tops of suction blisters in the treatment of vitiligo. Arch Dermatol. 1988; 124: 1656-1658 Crossref PubMed Scopus (149) Google Scholar and acetate sheets. 4 Albert S. Shenoi S.D. Acetate sheets in the transfer of epidermal grafts in vitiligo. J Am Acad Dermatol. 2001; 44: 719-720 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar This step is crucial because of the flimsiness of the epidermal graft and its tendency to curl toward either surface (epidermal or dermal), which may result in graft failure if the wrong graft surface is applied. 1 Tang W.Y. De Han J. Lu N.Z. Chan L.Y. Lo K.K. Surgical pearl: fine gauze is a useful carrier for epidermal graft in the treatment of vitiligo by means of the suction blister method. J Am Acad Dermatol. 1999; 40: 247-249 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar An ideal transport material is one that provides a firm, flexible platform, and allows for easy manipulation especially for small grafts. The transport material or platform needs to be sterile, should avoid adherence of the graft to the material, and should prevent curling of the epidermal graft.