Costs Effectiveness of Fractional Full-Thickness Skin Harvesting (FFTSG) Using an Automated Harvesting Device vs. Split-Thickness Skin Grafting (STSG) Performed in an Outpatient Setting

Introduction: Split-thickness skin grafting (STSG) autologous grafting is the gold standard method for restoring the structural integrity of wounds. STSG involves harvesting of the epidermis and upper dermis from a donor site. This process is often done manually, requires an operating room, and is associated with significant morbidity, namely pain at the donor site. Fractional full-thickness skin grafting harvests 316 micro-columns from a donor site done outside of an operating room with local anesthesia resulting in a significant decrease in donor site pain and cost as compared to a STSG.

Objective: The report compares the financial outcomes at the donor site and cost reduction when using a novel fractional FTSG (FFTSG) harvesting device outside of the operating room (OR) compared to a split-thickness skin grafting in patients with a variety of wounds performed in the OR.

Method: Examine a series of recent posters that addresses the donor site benefits of FFTSG and, specifically, the reduction in pain at the time of harvesting and the immediate days following for up to seven days. All procedures were performed in the outpatient setting even with wound size ranging from 2–270 cm².

Results: The cost to perform the entire procedure was under $1,3006 versus a traditional STSG done as an outpatient procedure in an OR costing over $2300.7 The average pain score during harvesting was 1.8 and 0.5 post-harvest with an initial average wound area of 66.98 cm² and a final wound area average of 23.44 cm². Often, donor pain necessitates prescription drugs to manage or at least over-the-counter pain medications.

Conclusion: The benefits, cost reduction, and reduced donor site morbidity without the need to schedule OR time to perform the procedure makes FFTSG an alternative to making the gold standard accessible to more patients.