An alternative method of skin grafting: the scalp microdermis graft

Although microskin grafting has been used successfully to treat major burns1–3, when the donor skin areas are inadequate, it is still not in popular use because of the difficulties of mincing and floating procedures. Floating is expected to produce more microskin patches with the dermal side upwards than with the epidermal side upwards. Another problem is that many microskin patches will be lost in the container during floating. This problem may be solved by preparing the microskin from the second layer scalp skin. This will be a graft of hair follicle cells, which can be sowed on the wound no matter which side is upwards. Grafting was carried out on well-prepared granulation beds, or on the fat surface after tangential excision, or on the bed after fascial excision of the burn. Allograft and Biobrane were used as cover dressings. The combination of fascial excision and allograft overlay gave an acceptable result. This can be an alternative method of skin grafting for burns with very limited donor skin areas when the scalp skin is not burned.