Modified Skin Graft Office Procedure

Introduction: In the setting of a stalled wound despite standard of care, a pinch graft can be performed in the outpatient setting to help promote wound closure.Methods:Partial thickness pinches of skin are taken from a donor site, usually the upper thigh. These are harvested using a scalpel and tooth Adson forceps and are placed onto the clean wound base. Prior to grafting, the wound bed should be free of necrotic tissue, and granulation tissue should be present. This is then covered with a contact layer and a foam dressing. The donor site is also covered with a foam dressing. This should be left intact for 5-7 days as to not disrupt graft incorporation.Results:Successful graft will provide coverage of the wound base. If graft does not take, stem cells and growth factors are still present, which benefit the wound base. This procedure can be repeated if there is improvement without complete closure.Discussion: We have seen successful wound closure of stalled wounds with assistance of a pinch graft.References: