Full thickness skin grafting with marginal de-epithelialization of the wound: Experience with two cases

Two cases are presented where large (25 mm and 45 mm diameter) skin cancers were removed followed by the application of full thickness skin grafts over the defect where the margins of these defects had been de-epithelialized in order to enhance the take of the full thickness skin grafts. FTSGs have a greater risk of failure as compared to split skin grafts (SSG). This relates to the thickness of the graft (split vs full thickness) and the time to vascularization of the defect bed (48 hours). It is proposed that de-epithelialization of the wound (recipient) margin provides an immediate partial wound vascular bed, reducing the need for adequate vascularization of the recipient wound bed. These cases suggest that with marginal de-epithelialization of the recipient wound margin, survival of a large skin graft can be enhanced.