Skin-Fat Composite Grafts for Reconstructing Large Full-Thickness Skin Defects

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Tissue Engineering

Background:

• The uppermost subcutaneous tissue contains a rich vascular network crucial for graft survival.
• Incorporating this vascularized layer into skin-fat composite grafts (SFCGs) enhances their viability.
• Previous methods focused on graft survival for large defect reconstruction.

Purpose of the Study:

• To evaluate the clinical outcomes of large skin-fat composite graft (SFCG) transplantations.
• To assess the efficacy of preserving vascular networks in SFCG survival and reconstruction.
• To determine the suitability of SFCGs for large, full-thickness skin defects.

Main Methods:

• Retrospective study of patients undergoing SFCG transplantation for large defects post-burn scar contracture or deformity excision.
• Recipient site preparation involved preserving deep scar tissue/reticular dermis to maintain vascularity.
• SFCGs were prepared by preserving interlobular septa and subdermal fat tissue (1-4mm thick).

Main Results:

• 88.4% of 86 SFCGs achieved complete survival (mean surface area 68.7cm²).
• Most grafts showed satisfactory pliability (93.0%), contour (90.7%), and color (88.4%).
• Complications like focal skin sloughing were minimal and often healed spontaneously.

Conclusions:

• SFCG transplantation with preserved vascular networks demonstrates high survival rates and good aesthetic results.
• This technique is effective for reconstructing large full-thickness skin defects.
• The preservation of vascularity in both graft and recipient sites is key to successful SFCG outcomes.