Postoperative Time and Anatomic Location Influence Skin Graft Reperfusion Assessed With Laser Speckle Contrast...

Area of Science:

• Dermatology
• Vascular Biology
• Tissue Engineering

Background:

• Skin graft microcirculation recovery is typically 8-12 days.
• Limited data exists on reperfusion dynamics beyond this period in dermato-oncology.
• Understanding long-term reperfusion is crucial for optimizing skin grafting outcomes.

Purpose of the Study:

• To characterize human skin graft reperfusion over 4 weeks.
• To investigate the influence of necrosis extension (<20% or 20-50%) on reperfusion.
• To analyze reperfusion patterns based on anatomic location (scalp, face, lower limb).

Main Methods:

• Laser speckle contrast imaging (LSCI) was used to assess perfusion.
• Perfusion was measured on graft surfaces on days 7, 14, 21, and 28 post-transplantation.
• Graft necrosis was evaluated on day 28, and perfusion was compared to adjacent control skin.

Main Results:

• Graft perfusion equaled control skin by day 7 and surpassed it by day 21, stabilizing thereafter, irrespective of necrosis.
• Grafts with <20% necrosis on the scalp and lower limb showed better center perfusion initially.
• Facial grafts exhibited perfusion similar to control skin from day 7, with no internal perfusion differences.

Conclusions:

• Skin graft reperfusion is a prolonged process influenced by time, location, and graft center/periphery dynamics.
• This detailed understanding can guide strategies for enhancing vessel ingrowth in tissue-engineered skin substitutes.
• Anatomic location significantly impacts the pattern and rate of skin graft reperfusion.