Donor Site Outcomes from Fractional Full Thickness Skin Harvesting Using an Automated Harvesting Device

Introduction: Split-thickness skin grafting (STSG) is the gold standard method for restoring the structural integrity of wounds in need of autologous tissue donation. 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. Automated epidermal harvesting systems have been used successfully when only the epidermis is necessary (Serena, 2015, Maderal, 2016). Nevertheless, because deep dermal structures are not harvested, the STSG and automated epidermal harvesting are limited by the depth of the graft. Full-thickness skin grafts (FTSG) are harvested when the epidermis and entire dermis are required for healing the wound. Since they contain more dermal structures, FTSGs are thought to be more efficacious in healing; however, they are associated with greater pain and scarring due to the degree of wound thickness that is required for harvesting. 

Objective: The current report describes the outcomes at the donor site when using a novel fractional FTSG (FFTSG) harvesting device in patients with a variety of wounds.  

Method: The harvesting device is designed to extract 316 “microcolumns” of full-thickness skin from a 12cm2 area in the anterior or lateral thigh regions.  We tested the harvesting abilities of the device in over a dozen patients who had a variety of wounds; local anesthetic was applied prior to harvesting, and all harvests occurred in an outpatient setting.

Results: Patients reported experiencing minimal-to-no pain at the harvested donor site. Additionally, full closure of the donor site occurs within a week to 10 days, with minimal-to-no complications and negligible scarring. 

Conclusion: We conclude that this FFTSG harvesting device successfully collected autologous, full-thickness microcolumns with minimal pain and was well tolerated.