Epidermal grafting is nothing but the transfer of skin (epidermis) from a normal donor area to the recipient area (affected area) without any processing. This technique is for treating smaller areas as there is no scope for grafts expansion.
In this method, firstly, a blister is created by suction pressure at the junction of dermis and epidermis (layers of skin). Next, the roof of the blister (thin epidermal graft) is moved to the recipient area.
Procedure1. The donor and recipient areas are cleared of hair follicles. The presence of hair follicles can prevent optimum graft uptake at the recipient site.
2. To create the suction pressure at the donor site, Leur-Lock disposable syringe, a three-way stopcock and a 50 ml syringe are used.
3. Once the blister forms, the grafts are harvested using curved iris scissors and transferred on a sterile glass slide which is smeared with an antibiotic ointment.
4. The recipient site is prepared for placing the graft. The surgeon may use any one of the techniques from the following: manual dermabrasion, motor dermabrasion, laser ablation etc.
5. The graft from the slide is then transferred to the recipient area with dermal side facing the graft bed. The area is then given a dressing comprised of collagen, paraffin gauze and normal sterile gauze.
6. The dressing is removed on day 7.
Advantages– The technique is easy, safe and effective.
– The recipient and donor areas heal without scarring.
– The colour match will be uniform without inward rolling of the graft edges.
Disadvantages– Large areas cannot be covered. Blisters are not always raised. The procedure is time-consuming.
– Handling the grafts can be difficult. Grafts may slip off from treated areas if not securely fixed.
– Hemorrhagic blisters may develop if negative pressure is not optimum.