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  • Title: Erbium:YAG laser-assisted preparation of a combined dermal/full thickness sandwich skin graft.
    Author: Bechara FG, Sand M, Radenhausen M, Sand D, Moussa G, Gambichler T, Altmeyer P, Hoffmann K.
    Journal: Dermatol Surg; 2006 Mar; 32(3):353-8. PubMed ID: 16640678.
    Abstract:
    BACKGROUND: Skin grafting is a common procedure to close defects after tumor resection. However, delicate areas such as the heel or the sole of the foot can be closed with a specially designed graft as described in this article. OBJECTIVE: To describe a surgical technique by means of erbium:YAG laser-assisted preparation of a combined dermal/full-thickness sandwich skin graft that facilitates the closure of defects, especially at mechanically stressed anatomic sites. METHODS: Tumor defects on the sole of the foot of 28 patients were closed with a new dermal/full-thickness sandwich skin graft. To obtain this special graft, half of a full-thickness skin graft twice the size of the wound defect was deepithelialized with an erbium:YAG laser. After complete defatting of the transplant, the deepithelialized part was folded beneath the full-thickness part (upside down) resulting in a sandwich graft, enabling contact of the papillary dermis with the wound surface. Graft results were graded as excellent when more than 75%, good if 50-75%, fair if 25-50%, and poor if less than 25% of the transplant healed. RESULTS: Results were graded as excellent in 32%, good in 54%, fair in 11%, and poor in 3% of the patients. Total graft loss was experienced in 1 of 28 patients. Complications such as bulky margins or infection were encountered in 14% of the patients. CONCLUSION: The laser-assisted preparation of the combined dermal/full-thickness sandwich skin graft is a new technique that facilitates the closure of defects in delicate anatomic locations with high mechanical stress like the plantar sole.
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