Split-thickness skin grafting using grafts of different thickness

Background Split-thickness skin grafting (STSG) is the most commonly used technique in the treatment of traumatic, post-burn, and post-operative wounds, when direct wound edge closure is unavailable. There is currently no general agreement on the optimal thickness of skin grafts. We aimed to analyze the early results of recipient wound healing after STSG, using grafts of different thicknesses. Methods This randomized, controlled, and parallel-group pilot clinical trial included 98 adult patients who underwent STSG transplantation surgery for post-burn, post-traumatic, or post-operative skin defects. Patients were randomized into three groups to receive a skin graft of 0.2, 0.3, or 0.4-mm thickness. After skin transplantation, the healing parameters of the recipient wounds were evaluated after 3 days, 7 days, 2 weeks, and 1 month. At each time, epithelialization and pain parameters were evaluated. Results Our study showed that thinner split-thickness skin grafts had better epithelialization scores at the second post-operative week. However, thinner split-thickness skin grafts caused greater pain to the patients. Conclusions Thickness of the skin graft is a significant factor affecting recipient wound healing parameters. It is necessary to evaluate healing of the donor wound, as well as distant treatment outcomes, such as scarring, pigmentation, and esthetic results of skin grafting with different thickness grafts. Level of Evidence: Level I, therapeutic study.