Full-thickness grafting from the ulnar border of the palm: outcome and donor-site morbidity.

Abstract

Full-thickness grafting from the ulnar border of the palm is an acceptable choice to cover appropriately sized defects of the volar surface of the hand. The outcome and donor-site morbidity are discussed. Twenty-two patients with variably located defects were treated with this technique. Mean age was 26.6 years and mean graft size was 3.8 × 1.6 cm. A number 15 scalpel was used to harvest the graft in a subdermal plane. The graft was secured with a tie-over dressing. The donor-site was closed primary with a continuous intradermal or "over-and-over" suture with few interrupted stitches. Color and texture match were adequate in 91% of the grafts. A contour defect with loss of the normal convexity of the ulnar border of the palm was noticed in 77% of donor sites. Hypertrophic scarring occurred in 3 patients (14%). Sensation in the 4 grafts covering fingertip areas was adequate (mean static 2 point discrimination: 5.5 mm). Mean follow-up was 12.7 months. The technique is useful in appropriately sized defects of the volar hand (within 6 × 3 cm). Donor-site morbidity and alternative techniques should be adequately discussed with the patient preoperatively.