Keywords
Zimmer pneumatic dermatome; Skin graft; Thickness
Abstract
Background: Skin grafting is a vital part of the treatment of deep skin defects. The preferred thickness of the graft is determined on the parameters of the wound which needs to be covered. Although, it is not known in how far the dial setting of the dermatome corresponds with the actual thickness of the harvested skin graft. To determine the usability of a dermatome setting regarding the resulting grafts thickness.
Methods: During the harvesting of split skin grafts in the operation theatre, the average thickness of harvested skin grafts was compared to the dermatome thickness settings.
Results: A total of 50 grafts were collected from 30 patients, leading to 250 thickness measurements (5 per graft). The measured thickness differed significantly from the dermatome setting: the grafts were up to 50% thinner than the dial setting when the settings of 0.25 mm and 0.30 mm were used. Scalp harvest thickness varied from 50% thinner to 200% thicker than the setting. Thickness was more or less constant across the skin grafts both lengthwise and laterally. We did not detect an effect of the blade becoming blunt regarding its accuracy after repeated use.
Conclusion: These results imply that the average measured skin graft thickness is up to 50% thinner than the thickness setting. Graft shrinkage alone does not seem to pose an adequate explanation for this difference. In scalp harvests, there is more variability in the thickness of the grafts. Furthermore, our results suggest that grafting blades do not have to be changed during the procedure, because we found no signs of bluntness.
Citation
Meij-de Vries A, Aartsen FE, Krijnen P, Roodbergen DT, Vloemans JFPM and Breederveld RS. The Dermatome and Its Thickness Setting: What You Set Is Not What You Get. SM Dermatolog J. 2017; 3(3): 1020.