Treating complex palmar-plantar wounds using a bilaminar 'trapdoor' technique: a case series

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Dermatology

Background:

• The plantar region is a suitable donor site for complex palmar-plantar wounds due to glabrous skin similarity.
• Traditional plantar grafts can cause donor site morbidity and poor integration due to thick corneal layers.

Purpose of the Study:

• To evaluate the efficacy of the bilaminar "trapdoor" technique for harvesting plantar skin grafts.
• To assess donor site healing, graft integration, and functional/aesthetic outcomes in palmar-plantar reconstruction.

Main Methods:

• A prospective case series involving patients with palmar-plantar wounds treated with the bilaminar "trapdoor" technique.
• The technique involves harvesting a thin graft from the deep plantar dermis after partial elevation of the superficial layer.

Main Results:

• Rapid donor site healing (around 10 days) with no hypertrophic scarring observed in four patients.
• Complete re-epithelialization of the deep dermal graft occurred within 2-3 weeks.
• Grafts maintained aesthetic and functional properties, resembling adjacent glabrous skin.

Conclusions:

• The bilaminar "trapdoor" technique offers reduced surgical time and minimal donor site morbidity.
• This method facilitates easy graft integration and preserves the functional and aesthetic qualities of glabrous skin.
• The technique is advantageous for both donor and recipient sites in palmar-plantar reconstruction.