Clinical study comparing full-thickness skin columns and split-thickness skin graft donor sites in terms of pain and healing outcomes.

Abstract

Split-thickness skin grafting (STSG) is the standard of care for treating major skin loss but is associated with significant donor site morbidity, including pain, prolonged healing, hypertrophic scarring, and pigmentation changes. Full-thickness skin column (FTSC) grafting has emerged as an alternative approach to transplant autologous skin in the management of full-thickness wounds. This clinical study evaluated an electronic FTSC harvesting and application device called the Autologous Regeneration of Tissue (ART). The ART device is designed to harvest 316 FTSCs from a small donor area and transplant them onto the recipient site in just a few minutes. A clinical study was conducted comparing donor site wounds created with the ART device to those created with a conventional dermatome to harvest STSGs. Patients with full-thickness wounds that required skin grafting were enrolled in the study. Donor sites using the ART device and a dermatome were created on each participant. The donor sites were followed for up to 60 days after harvesting and were assessed for inflammation, pain, healing, and scarring on days 3, 7, 14, 30, and 60. In total, the study included five patients, and five ART donor sites were compared with five STSG donor sites. The results showed that by day 7, all the ART donor sites were fully healed, while the STSG donor sites were near full closure (97 %) by day 14. Pain measured using the 0-10 visual analog scale (VAS) indicated significantly less pain in the ART donor sites on day 7. Quality of healing measures using both the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS) showed significantly less scarring in the ART donor sites on postoperative day and 60. It was shown that the ART device was easy to use and enabled the harvesting of hundreds of FTSCs from a small donor area and their application onto the recipient site in just a couple of minutes. The ART donor site exhibited faster healing, reduced pain, and less inflammation and scarring. However, due to the small sample size, these results should be considered preliminary.