Re-epithelialization via Fractional Full Thickness Skin Grafting using an Automated Harvesting Device

Introduction: Autologous skin grafts can augment the healing of certain wounds, with both split-thickness skin grafts (STSGs) and full-thickness skin grafts (FTSGs) being options. Harvesting STSGs or FTSGs typically requires an operating room and is associated with significant morbidity at the donor site. However, given that they contain deeper dermal structures, FTSGs can provide the wound bed with more of the necessary substrates for healing, but are associated with greater pain and scarring. Due to the degree of wound thickness that is required for harvesting, technological innovations have sought to provide autologous grafting options that reduce the pain and other morbidities caused by STSGs or FTSGs. 

Objective: We report the use of a novel fractional FTSG harvesting device associated with minimal pain at the donor site in patients with chronic wounds. 

Method: The harvesting device is designed to harvest and scatter 316 “microcolumns” of full thickness skin into the wound bed.  We utilized this method of grafting in over a dozen patients with a variety of wounds, including, venous leg ulcers, abdominal wounds and amputee cases. Initial size of the wounds varied, with the largest measuring at nearly 100 cm2. The wound site was observed and documented two times per week for each patient, with the critical endpoints being percent re-epithelialization and time to complete healing. 

Results: In general, wound healing progression was observed within the first 1-2 weeks post-grafting and continued favorably, with several patients showing complete or near-complete healing on average by Week 5.  

Conclusion: We conclude that this alternate method of harvesting FTSGs provides the advantages of autologous skin grafting with less pain and decreased need for ancillary services than traditional methods.