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Skin grafts have remained relatively unchanged since their introduction as a medical treatment for burns/wounds. This paper seeks to open an academic discussion as to whether their use-by date has now been passed. A skin graft substitute is described in a paradigm using fine leaf gelatine sheets which inherently possess several distinct advantages including, discarding the harvest of autologous tissue from patient donor sites. A clinical study will be needed to determine its suitability taken together with the understanding that experimental animal studies may not provide unequivocal answers to its in situ modus operandi.

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Perineal Reconstruction with Thick Split-Thickness Skin Grafts following Fournier’s Gangrene and Traumatic Perineal Degloving Injury: A Case Report [PDF]
Emile Kouakou Tano, Peter Agyekum Boateng, Francis Quenin, Priscilla Felicia Tano, Patrick Opoku Manu Maison
Surgical Science (SS) , 2026, DOI: 10.4236/ss.2026.1710039

Abstract: Background: Perineal reconstruction following extensive soft tissue loss presents a formidable surgical challenge, particularly in resource-limited settings where advanced reconstructive options may not be readily available. Both Fournier’s gangrene and traumatic degloving injuries can leave large perineal defects that demand reliable, cost-effective, and technically accessible solutions. Case Presentation: The authors report two adult male patients managed at two major referral centres in Ghana. The first was a 67-year-old hypertensive farmer who presented with circumferential penile and scrotal wounds secondary to Fournier’s gangrene. After serial debridement and wound optimisation, we reconstructed the penile shaft with a thick split-thickness skin graft (TSTSG), while the scrotal defect was closed primarily, with 100% graft take on post-operative day 10 and satisfactory functional recovery at eight weeks. The second was a 28-year-old farmer who sustained a complete perineal degloving injury in a road traffic accident. After three weeks of wound bed preparation, the scrotum was reconstructed with bilateral random cutaneous thigh flaps and the penile shaft with a TSTSG, with full wound healing at three months and preserved penile sensation and erectile function. Conclusion: Thick split-thickness skin grafting, used alone or in combination with local flaps, is a practical, reliable, and reproducible reconstructive strategy for complex perineal defects in low-resource settings. These cases support its broader adoption as a first-line option when free flaps or specialised tissue-engineering modalities are unavailable.

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Injerto óseo simultáneo a la colocación de implantes: A propósito de un caso
Pe？arrocha Diago,Miguel; Gómez Adrián,Ma Dolores; García Mira,Berta; Ivorra Sais,Mariola;
Medicina Oral, Patología Oral y Cirugía Bucal (Ed. impresa) , 2005,

Abstract: bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. we describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. the grafts were stabilized by positioning the dental implants through them - a procedure that moreover afforded good primary implant fixation. after two years of follow-up the clinical and radiological outcome is good. in the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient - minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

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Utilizing Free Skin Grafts in the Repair of Surgical Wounds [PDF]
Madalene C. Y. Heng
Journal of Cosmetics, Dermatological Sciences and Applications (JCDSA) , 2012, DOI: 10.4236/jcdsa.2012.23037

Abstract: The use of free grafts to close defects in wounds following surgery has long been utilized in dermatology practice. However, because of the low survival of the grafts, their popularity has dwindled over recent years. The use of techniques such as attaching an “umbilical cord” from the base of the grafts to the underlying deep fascia or cartilage has markedly increased graft survival. In this paper, the scope of free grafts is presented, showing survival of even large grafts if anchored to the deep tissue with multiple “umbilical cord” attachments. The advantages of full-thickness free skin grafts include the ability to close the wound immediately following removal of the tumor, with decreased risk of infection and pain, requiring fewer dressing changes and visits. The technique of close stitching, with interrupted sutures 1 - 2 mm apart, prevents contact of the wound with oxygen from the air, resulting in increased graft survival from revascularization of the free graft. With the added use of extra-strength curcumin gel, perfect regeneration may be achieved. In addition, in most free grafts, it was observed that there was recovery of sensation due to presumed nerve regeneration.

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Reconstruction of Post Burn Neck Contracture Using Full Thickness Skin Graft [PDF]
Dalia M. El Sakka, Belal A. Al Mobarak, Mohamed Elsayed Mohamed Mohamed
Modern Plastic Surgery (MPS) , 2018, DOI: 10.4236/mps.2018.82004

Abstract: Background: Neck contracture after burns is a major complication that affects function and cosmesis. The aim of covering the raw area and defects is through using good quality pliable skin. Full thickness skin graft allows a large dimension sheet of good quality skin with low donor-site morbidity. Also it provides similar skin quality to the recipient areas with much less cosmetic difference. Methods: Four men and eight women underwent neck contracture release and reconstruction from December of 2015 to August of 2016. Mean patient age was 29 years (range from 12 to 46 years). Burn scar contracture releases were performed and cervicoplasty was added for optimal neck appearance. Uniformly full thickness skin grafts were applied. Both lateral ends of these grafts (release incisions) were designed with a fishtail shape for sufficient release and to minimize linear scar band formation in the most lateral region of the neck. Results: Full thickness skin grafts as large as 24 ± 12 cm (in length) and 10 - 15 cm (in width) were used. All grafts were taken without significant complications. Range of neck motion

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Viability of Split Thickness Autogenous Skin Transplantation in Canine Distal Limb Reconstruction – An Experimental Evaluation
M. S. Ijaz, A. K. Mahmood, N. Ahmad1, M. A. Khan, and U. Farooq
Pakistan Veterinary Journal , 2012,

Abstract: Distal limb reconstruction is complicated by the paucity of local tissues and the frequent association of orthopedic injury with cutaneous loss. Though, second-intention healing or skin stretching techniques are used for wounds involving less than a 30% circumference of the limb, however, skin grafts are recommended for reconstruction of larger superficial wounds. The present study was designed to clinically evaluate the viability of split thickness autogenous skin transplantation (STAST) in dogs. Standardized surgical defects of variable size i.e. 3×3, 4×4 and 5×5 sq cm were made on the left middle radial area (forearm) of 15 mongrel dogs assigned to Group A, B and C, respectively having 5 dogs each. Split thickness autogenous skin grafts were harvested from mid thorax and placed in these defects through several simple interrupted sutures. Results indicated a success rate of 80% with no clinical difference in the survival rate of three different sizes of grafts used. Hence, STAST can successfully be used for canine distal limb reconstruction.

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Use of autologous grafts in the treatment of acquired penile curvature: An experience of 33 cases
Abdul Rouf Khawaja,Arf Hamid,Arsheed Iqbal,B. S. Wazir,M. S. Wani,Sheikh Tariq,Suhael Zahur,Tanveer Iqbal Dar
- , 2016, DOI: 10.4103/0974-7796.176875

Abstract:

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The modified use of Surfasoft？ in skin grafts: case series
A. Farroha,A. Salibi,M. Chasapi
- , 2016,

Abstract: Surfasoft？ is a monofilament woven polyamide thread. Its use over skin grafts has always been combined with other occlusive dressings. Its rapid application and transparent property makes it an ideal primary dressing in the absence of any occlusive layers after the first two days following skin graft application. We describe this modified use in our case series. We modified the use of Surfasoft？ in four different burns patients and one skin cancer case. Surfasoft？ was predominantly used on difficult sites and secured with either staples or sutures. A secondary occlusive dressing was only applied in the first 48 hours, then removed, leaving Surfasoft？ as a single dressing until it spontaneously separated from the graft approximately 7-10 days post op. Complete healing of grafts was defined when dressing was no longer required. The majority of burns were full thickness with an average TBSA of 6.5%. Distribution was mainly to the neck and upper torso areas. The skin cancer was located on the right shoulder region. Graft healing was completed in 3-4 weeks following surgery. No complications were reported. Advantages of the modified Surfasoft？ in addition to factors associated with graft survival in our series are discussed. The modified Surfasoft？ was shown to be a simple and reliable dressing for meshed STSGs in both burns and elective procedures. We believe that it can be effectively used in sites associated with poor tolerance to conventional dressing and when nursing resources are limited

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Correlation of MRI Appearance of Autologous Chondrocyte Implantation in the Ankle with Clinical Outcome
Brian Kern,Gregory R. Applegate,Keith W. Chan,Richard D. Ferkel,Sarah S. Chan
- , 2018, DOI: 10.1177/1947603516681131

Abstract: The objective of this study was to characterize magnetic resonance imaging (MRI) findings and correlate with clinical results in patients who underwent autologous chondrocyte implantation (ACI) of osteochondral lesions of the talus (OLT). Methods. Twenty-four grafts were evaluated at a mean 65.8 months after ACI for OLT. MRI was performed on a 1.5-T GE scanner using multiple sequences. Graft appearance was compared with preoperative MRI and evaluated for 6 criteria: defect fill, surface regularity, signal pattern, bone marrow edema, subchondral plate irregularity, and presence of cystic lesions. Clinical outcome was measured with the American Orthopaedic Foot and Ankle Society (AOFAS) clinical outcome score. Results. Of 24 grafts, 22 (92%) demonstrated >75% defect fill. Eighteen (75%) had a mildly irregular and 6 (25%) had a moderately irregular articular surface. The signal pattern of the repair tissue was heterogenous in 23 (96%); 14 (58%) layered and 9 (38%) mottled. Fourteen grafts (58%) showed decreased amount of bone marrow edema while 4 (17%) had no change and 5 (21%) had an increase in the amount of bone marrow edema. The subchondral bone plate was abnormal in most grafts, with focal defects seen in 10, slight depression in 7, and both in 5. Seven had an increase in cystic lesions while the others had no change, decrease or no cysts seen. Mean postoperative AOFAS score was 87.5 with mean improvement of 39.4. Conclusions. At 66-month mean follow-up, MRI appearance of the ACI grafts show imaging abnormalities but demonstrate good clinical results. While MRI is an important tool in the postoperative assessment of ACI grafts, the various variations from a normal/nonoperative ankle must be interpreted with caution

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Autologous serum therapy in chronic urticaria: Old wine in a new bottle
Bajaj A,Saraswat Abir,Upadhyay Amitabh,Damisetty Rajetha
Indian Journal of Dermatology, Venereology and Leprology , 2008,

Abstract: Background: Chronic urticaria (CU) is one of the most challenging and frustrating therapeutic problems faced by a dermatologist. A recent demonstration of abnormal type 1 reactions to intradermal autologous serum injections in some CU patients has led to the characterization of a new subgroup of "autoimmune chronic urticaria". This has rekindled interest in the age-old practice of autologous blood injections as a theoretically sound treatment option in these patients. Aims: To evaluate the efficacy of repeated autologous serum injections (ASIs) in patients with recalcitrant chronic urticaria. Methods: A cohort of 62 (32 females) CU patients with a positive autologous serum skin test (ASST) (group 1) was prospectively analyzed for the efficacy of nine consecutive weekly autologous serum injections with a postintervention follow-up of 12 weeks. Another group of 13 (seven females) CU patients with negative ASST (group 2) was also treated similarly. In both groups, six separate parameters of disease severity and activity were recorded. Results: Demographic and disease variables were comparable in both groups. The mean duration of disease was 1.9 ± 0.3 years (range = 3 months to 32 years) in group 1 and 1.5 ± 0.2 years (range = 3 months to 10 years) in group 2. In the ASST (+) group, 35.5% patients were completely asymptomatic at the end of the follow-up while an additional 24.2% were markedly improved. In the ASST ( ) group, these figures were 23 and 23% respectively. The intergroup difference for complete subsidence was statistically significant (P < 0.05). In both groups, the most marked reduction was seen in pruritus and antihistamine use scores followed by the size and frequency of the wheals. Conclusion: Autologous serum therapy is effective in a significant proportion of ASST (+) patients with CU. A smaller but still substantial number of ASST ( ) patients also benefited from this treatment.

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