gms | German Medical Science

Background: Small (<1% of total body surface area) non-healing burn wounds can be a significant nuisance to patients and providers and sometimes do not respond to conventional treatments. Epidermal grafting, which can be performed in an office setting, may provide an option for patients with small, non-healing burn wounds, who cannot or do not want to tolerate anesthesia. This case series presents patients who were not surgical candidates and whose small, non-healing burn wounds received epidermal skin grafts (ESGs).

Methodology: After wound bed preparation based on institutional protocol was performed, an epidermal harvesting system* was used to harvest ESGs. Donor sites (thigh) were prepared by removing hair and washing with an antiseptic^† and saline rinse. The harvester applied heat and suction to raise epidermal skin into microdomes in a “fractional” fashion. After harvesting, a fenestrated adhesive dressing was used to transfer microdomes to the recipient site. Gauze and self-adherent wrap were used as outer dressing.

Results: Three patients with small, non-healing burn wounds on left leg, right shin, and left foot, respectively, received ESGs. Patients reported minimal pain during harvesting and fewer dressing changes than with conventional wound care. There was no disruption to their daily lives (eg, no hospital stay, no NPO). Wounds were fully healed by 4 weeks post-grafting. No complications were reported; donor sites healed without complications or visible scarring by week 2.

Conclusions/Discussion: In these patients, epidermal grafting provided a viable option for wound management with minimal donor site morbidity.

*CELLUTOME™ Epidermal Harvesting System, KCI, an ACELITY Company, San Antonio, TX

^†HIBIBLENS^® (Mölnlycke Health Care, Norcross, GA)