Journal List > J Korean Soc Surg Hand > v.19(3) > 1106456

Kim, Lee, Hwang, Jung, and Kim: The Usefulness of Retroauricular Full Thickness Skin Graft in Hand Reconstruction

Abstract

Purpose:

We used the retroauricular area skin as an alternative full-thickness skin donor site in the hand reconstruction surgery.

Methods:

From January 2006 to March 2013, 55 patients observed more than 1 year, were recruited for the study. In case of requiring the skin graft on hand, we grafted skins were harvested from the retroauricular area on hand. To assess the subjective and objective satisfaction, the patients themselves and three doctors compared the skin graft area's color with adjacent skin and estimated the donor site scar on a five-point scale.

Results:

A partial necrosis was seen in one case who received skin graft because of a burn scar contracture, but it was cured with conservative treatment. In other cases, the skin graft was well taken without any specific problems. The retroauricular skin graft showed good color match with adjacent skin and less pigmentation. Donor site scar was not noticeable. As a result, the patient's subjective satisfaction (4.07) and doctor's objective satisfaction (4.18) about skin graft were very good. And the patient's subjective satisfaction (4.93) and doctor's objective satisfaction (4.98) about donor site scar were also very good.

Conclusion:

We obtained the favorable result and the patients satisfaction by using the retroauricular area as a full thickness skin graft donor site in hand.

REFERENCES

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Fig. 1.
(A) A 3-year-old boy who was born with syndactyly on third and fourth left finger. (B) Intraoperative finding shows 3.5 × 1.5 cm sized right retroauricular skin design to cover the third finger raw surface area. (C) Good color matching with surrounding tissues without any hyperpigmentation at 1 year after operation.
jkssh-19-109f1.tif
Fig. 2.
(A) 7 cm sized hypertrophic and scar contracture at left wrist. (B) Intra-operative finding shows grafting on right wrist with 7.0×2.5 cm sized skin harvesting on left retroauricular area and the donor site closed directly. (C) Postoperative finding at 18 months after surgery shows the correction of contracture and good color match with surrounding tissues without any hyperpigmentation. Moreover, donor site scar was obscure.
jkssh-19-109f2.tif
Fig. 3.
(A) 3.0 × 1.5 cm sized skin defect on third left finger. (B) Good color matching with surrounding tissues without any hyperpigmentation at 3 years after surgery.
jkssh-19-109f3.tif
Table 1.
Patients profile
Characteristic No. Average graft size (cm2) Graft take rate (%)
Congenital anomaly 9 4.5 100
Trauma 25 11.3 100
Scar contracture 21 8.0 95
Table 2.
Result of the skin graft area
Characteristic Patient Physicians*
Very well matching (5 point) 9 15
Well matching (4 point) 42 35
Moderate matching (3 point) 3 5
Poor matching (2 point) 1 0
Very poor matching (1 point) 0 0
Average 4.07 4.18

* The results were assessed by three clinical physician.

Table 3.
Result of the donor site scar
Characteristic Patient Physicians*
Very well state (5 point) 53 54
Well state (4 point) 0 1
Moderate state (3 point) 2 0
Poor state (2 point) 0 0
Very poor state (1 point) 0 0
Average 4.93 4.98

* The results were assessed by three clinical physician.

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