The “Swing-Door” Regrafting of Donor Site: An Alternative Method for Split-Thickness Skin Graft in the Hand

Abstract

Background Skin defects in the hands are common injuries, and autologous skin grafting is the ideal treatment. However, complications can occur at the donor and recipient sites. This study compares the “Swing-door” technique with conventional skin grafting.

Methods From August 2019 to February 2023, 19 patients with skin defects of hand underwent the “Swing-door” split-thickness skin graft (STSG) technique. The thin epithelial layer was elevated with proximal part attached. Skin graft was harvested beneath. Donor site was then closed with epithelial flap like a “Swing-door”. The outcomes were evaluated in terms of healing time, scar formation, and pain at the 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 Analog Scale.

Conclusion The “Swing-door” STSG is a useful alternative for treating hand skin defects.

Keywords

hand injury - wound healing - skin transplantation - hand

Authors' Contributions

Conceptualization: J.S.K.; data curation: C.J.P.; formal analysis: S.H.K., D.C.L., S.Y.R, and K.J.L.; writing—original draft: C.J.P.; writing—review and editing: J.S.K. C.J.P. All authors have read and approved the final manuscript.

Ethical Approval

This study was performed in accordance with the principles of the Declaration of Helsinki. The study design was approved by the Institutional Review Board of Gwangmyeong Sungae Hospital (KIRB-2023-N-003).

Patient Consent

The patients have provided written informed consent for the publication and use of images.

Publikationsverlauf

Eingereicht: 02. Mai 2023

Angenommen: 03. September 2023

Accepted Manuscript online:
05. September 2023

Artikel online veröffentlicht:
28. Februar 2024

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