Patterns of contraction in human full thickness skin grafts

• Published in: British journal of plastic surgery Vol. 53; no. 5; pp. 397 - 402
• Main Authors: Stephenson, A.J., Griffiths, R.W., Hausse-Brown, T. La
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2000; Elsevier
• Subjects: Age Factors; Aged; Aged, 80 and over; anatomical site; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biological and medical sciences; contraction; Female; full thickness skin grafts; Humans; Immunosuppressive Agents - therapeutic use; Male; Medical sciences; Middle Aged; Photography; Prospective Studies; Skin plastic surgery; Skin Transplantation - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - physiology; Time Factors; Treatment Outcome; Wound Infection - pathology; full thickness skin grafts; contraction; anatomical site; Thickness; Human; Prospective; Site; Treatment; Surgery; Characteristic; Graft; Skin; Anatomy; Contraction; Result
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1054/bjps.2000.3335

It is taught that full thickness skin grafts contract minimally in humans. We aimed to examine thisassumption.
In a prospective study, a scale photograph of each of 54 human full thickness skin grafts was taken at operation once the graft had been inset, but before the application of any tie-over or other dressing. For 50 grafts, a subsequent scale photograph was taken at follow-up (mean 111 days post-operation). The photographs were digitised and the areas of the grafts recorded.
Significant area reduction in human full thickness skin grafts was found (
P<0.01, mean area change −38%).Greater contraction was associated with infection than without (
P=0.02, mean area change with infection −48%, without infection −33%). Full thickness skin grafts applied to the peri-orbital area and nose contracted more than those applied to the scalp and temples (
P=0.002).
No differences in contraction were found between donor sites, between methods of fixation, between males and females or between those taking no medication and those taking steroids or non-steroidal anti-inflammatory medication. Area change did not correlate with initial graft area, patient age or time to second photograph.