Delayed grafting for banked skin graft in lymph node flap transfer

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Lymphedema Management

Background:

• Lymph node flap (LNF) transfer is a key treatment for extremity lymphoedema.
• Primary closure of LNF recipient sites is often not feasible, necessitating split-thickness skin grafts (STSG).
• Partial STSG loss is a common complication, leading to suboptimal outcomes.

Observation:

• This study investigated the efficacy of delayed autologous banked STSG for resurfacing LNF recipient sites in 10 patients with Stage II-III lymphoedema.
• STSG were harvested and banked, with delayed grafting performed on postoperative days 4-6 as a bedside procedure.
• Flap viability was confirmed, and swelling allowed to subside before grafting.

Findings:

• 100% flap survival was achieved.
• Delayed STSG demonstrated over 97% graft take.
• Patients experienced minimal pain, reduced graft requirements, and high satisfaction with aesthetic results.
• No complications were reported at graft or donor sites during follow-up.

Implications:

• Delayed skin grafting is a reliable and effective method for LNF recipient site reconstruction.
• This technique reduces flap complications, operative time, and costs.
• It offers a promising approach to improve outcomes in lymphoedema surgery.