The "Swing-Door" regrafting of donor site; An Alternative Method for Split-Thickness Skin Graft in the Hand

Abstract

Purpose: Skin defects in hands are common injuries, and autologous skin grafting is the ideal treatment. However, complications can occur at donor and recipient sites. This study compares the "Swing-door" technique with conventional skin grafting. Patients and methods: From August 2019 to February 2023, 19 patients with skin defects of hand underwent the "Swing-door" STSG technique. Thin epithelial layer was elevated with proximal part attached. Skin graft was harvested beneath. Donor site was closed with epithelial flap like a “Swing-door”. The outcomes were evaluated in terms of healing time, scar formation, and pain at donor and recipient sites. The data were compared with the conventional STSG. Results: The "Swing door" group had lower graft take percentages, but complications did not significantly differ between the two groups. The "Swing-door" technique resulted in better cosmetic outcomes, as evidenced by lower Vancouver Scar Scale scores, faster donor site epithelialization, and reduced pain and discomfort during the early postoperative period, as measured by Visual Analogue Scale. Conclusion: The "Swing door" STSG is a useful alternative for treating hand skin defects.