Skin grafting is widely used for healthy raw areas. The advantages of meshing include
prevention of seroma or hematoma underneath the graft and to cover a larger surface
of wound area. The techniques for meshing are many, including[1]
[2]
[3] machine meshers introduced by Tanner et al in 1964. Usually, manual hand meshing
techniques are sufficient using sharp blades and a hard surface underneath the graft.[1]
[2]
[3] We described a novel and efficient hand-based skin graft meshing technique using
autoclaved foam.
Our technique requires a piece of autoclaved foam (polyurethane foam) and a 11 size
blade with handle ([Fig. 1]). Skin graft is spread over the foam with dermis facing the roof ([Fig. 2]).The graft is meshed by making multiple perforations with the 11 size blade at an
almost perpendicular to the skin graft ([Fig. 2]) ([Video 1], available in the online version only) ([Video 2], available in the online version only). The perforations are made according to the
recipient area. Once the graft is secured and the graft is layered by paraffin gauze
and same foam can be used as pressure dressing or vac dressing.
Fig. 1 Materials for our technique of hand meshing.
Fig. 2 Skin graft is spread over the foam with dermis facing the roof and meshing with an
11 size blade perpendicular to the graft.
Video 1 Routine method of hard surface underneath the graft and our foam technique.
Video 2 Only our foam technique.
There are many ways of meshing a skin graft that have been described in the literature[1]
[2]
[3]. Each technique has its own disadvantages such as damage to the graft, non-availability
of materials, and donor site morbidity. Meshing against wooden board or kidney tray
is widely used. However, it is time consuming, perforations are not good enough, and
slippages of graft are major disadvantages. The advantages of machine meshers include
meshing larger grafts and uniform fenestrations. Limitations of using the meshers
include availability of meshers, cost, time-consuming, sometimes an assistant's help
is required, and mechanical failure leads to damage of the skin graft .With all these
limitations of above-mentioned procedures, we have introduced our hand meshing technique
with readily available materials. In our center for all the cases that required skin
resurfacing, especially medium-to-large sized split thickness skin grafts, we used
this technique and found to have excellent outcomes. The advantages of our procedure
is reduced cost, access to materials, ease of performing, less time consuming, effortless
meshing, and the option of using the foam material for VAC dressing.
This novel technique of split thickness skin graft meshing by hand, using an 11 size
SS blade over an autoclaved foam slab is a simple, fast, and effortless method of
hand meshing compared with other traditional techniques. Hence, we recommend this
technique to mesh large areas of grafts in a shorter time.
