Harvesting Split-thickness Skin from the Scalp Using a Scalpel.

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Split-thickness skin grafts (STSGs) from the scalp present an alternative for patients avoiding scars on extremities.
• Limited equipment availability at some institutions can hinder traditional STSGs.

Purpose of the Study:

• To evaluate the efficacy and safety of harvesting STSGs from the scalp using a simple scalpel technique.
• To assess donor site healing, graft take, and aesthetic outcomes for recipient sites.

Main Methods:

• STSGs were harvested from the scalps of 4 patients using a No. 15 blade under local anesthesia.
• Grafts were used for small defects (facial trauma, tattoo, scarring) and one large burn defect.
• Donor site epithelialization, graft take, secondary contraction, and recipient site aesthetics were monitored; histopathology confirmed skin thickness and follicle integrity.

Main Results:

• Mean patient age was 39.8 years; 2 were male.
• Donor sites achieved epithelialization in a mean of 8.75 days with no hypertrophic scarring or alopecia.
• Good graft take and acceptable color/texture match were observed, with mild secondary contraction in two cases.
• Histopathology confirmed harvested skin thickness of 0.3–0.7 mm, with intact hair follicles.

Conclusions:

• The scalpel technique for scalp STSGs is a cost-effective method requiring minimal equipment.
• Harvesting skin <1 mm thick preserves hair follicles, ensuring rapid donor site healing and avoiding limb/trunk scarring.
• This technique is particularly suitable for covering small defects effectively.