Primary split thickness skin grafting for hand and finger defects: Do not hesitate

Abstract

Introduction: Hand injuries often result in soft tissue defects. The treatment of these defects belongs to the most difficult challenges in reconstructive surgery. There are numerous options for covering soft tissue defects, including flaps and skin grafts. Material and methods: This retrospective observational study included seventeen patients with 24 skin defects of the hand, who were treated by primary split-thickness skin graft (STSG) in a single center. The average follow-up period was 6 months. The age of the patients ranged from 36 to 80 years. The majority of patients (n=16) were males, and one patient was female. Skin defects varied in size from 7x8mm to 39x40mm. Primary goals were STSG survival, recipient site infection, and donor site morbidity. Secondary goals were cosmetic appearance and time needed for complete wound healing. Results: All 24 wounds healed successfully in a mean of 28,11±9,94 days. There were no graft infections. Partial graft loss occurred in one case. There was no major donor site morbidity reported. Six patients described the cosmetic result as good (score 3), 10 patients dde-scribed it as acceptable (score 2), and one patient described it as poor (score 1). Conclusion: Split thickness skin graft is an excellent option for immediate treatment of hand and finger skin defects. This method is simple , has less consequences than secondary grafts, requires minimum equipment and can sometimes be done in the emergency room, without hospitalization. Therefore, there is no need to be afraid of primary skin grafting.