Pressure Injury, Diabetes and Negative Pressure Wound Therapy by Melvin A. Shiffman & Mervin Low

Author:Melvin A. Shiffman & Mervin Low
Language: eng
Format: epub
ISBN: 9783030107017
Publisher: Springer International Publishing

12.2 Skin Contraction in Skin Grafts

Two types of skin contraction occur with skin grafting. Primary contraction occurs at the graft site, where the graft is removed from the donor site. Contraction occurs greater in full-thickness skin grafts than in split-thickness skin grafts, likely from the elastin fibers in the dermis [76, 91, 92, 216, 217]. Full-thickness skin grafts retract approximately 44%, intermediate.

Split-thickness skin grafts retract approximately 22%, and thin split-thickness skin grafts retract approximately 9% [56, 57, 98]. Tension applied to the graft when it is applied to the recipient bed reestablishes graft length and width. Secondary contraction occurs once the graft is fixed to the recipient bed [217]. Secondary contraction results from the host bed myofibroblasts within the wound pulling the skin graft. Full-thickness skin grafts are more resistant to secondary contraction than split-thickness skin grafts [90]. The greater the percentage of dermis in the graft, the less the skin graft contracts secondarily. Therefore, the greater the relative thickness of graft dermis, the speedier the myofibroblast life cycle [217]. Thus, full-thickness skin grafts resist secondary contraction better than thin split-thickness skin grafts [14, 91, 92, 98, 212, 218].

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