抄録
Background: Infection of the grafted site or insufficient wound bed preparation can lead to skin graft failure. Therefore, we performed the buried patch skin graft technique using a granulation flap under local anesthesia in severe local wound site infections or severe general conditions. This report aims to demonstrate the utility and indications of this technique.
Methods: A small split-thickness patch of skin was grafted beneath the granulation flap in cases with persistent chronic wounds secondary to skin graft loss after conventional split-thickness skin grafting under general anesthesia. Multiple square granulation flaps were elevated at all corners at straight angles. The skin graft patch was placed beneath these flaps, which measured 1–4 cm2. Both corners of the distal end of the flap were secured using absorbable sutures. The topical ointment dressing was changed daily.
Results: This technique was performed in 10 patients under local anesthesia at the bedside or outpatient room. Survival and vascularization of the grafted skin were confirmed in all cases. The granulation flaps gradually fell between postoperative days 3 and 7. All cases, excluding two fatal cases, achieved wound closure.
Conclusions: Buried patch skin grafting under a granulation flap should be considered in cases with insufficient wound bed preparation or compromised general condition to reduce the risk of skin graft loss.
