Our Experience With Glabrous Skin Grafts for Hand Injuries

Hand injuries requiring skin cover may utilize skin harvested from the instep of the foot. We present a series of such cases with a follow-up period of 6 months following glabrous skin grafting.

To evaluate the aesthetic and functional outcome of using glabrous skin to cover skin defects in the hand.

All patients with raw areas of the hand who presented to our institution's department of plastic surgery between August 2021 and August 2022 were included in the study. The Patient and Observer Scar Assessment Scale (POSAS) was used to serially assess the quality of scar over a period of 6 months. The instep of either foot was chosen as the donor site. POSAS scores for the resulting scar were collected at 1 month, 3 months, and 6 months postoperatively. Outcomes were analyzed using SPSS software.

A total of 15 cases were included in the study. Average preoperative POSAS score by patients was found to be 52/60, whereas the average score given by the observer (physician) was 51/60. At 1 month after glabrous skin grafting, patients scored an average of 33/60, whereas the average observer score was 31/60. At 3 months, there was marked improvement in quality of the scars, with an average patient score of 20/60 and observer score of 19/60. At the final follow-up of 6 months, most patients had minimum symptoms and reported an average score of 7/60 and observer score of 6.2/60.

In our study, we found excellent graft uptake, good functional outcome, adequate color match, improved scar quality, and minimal donor site scarring.