We describe a technique of freehand scalpel harvesting, whereby the split‐thickness skin graft (STSG) to be harvested is outlined and the margin scored with a scalpel prior to freehand scalpel harvesting. We term this technique ‘score and shave’, and describe it with illustrative cases in the reconstruction of surgical wounds following Mohs micrographic surgery (MMS) and standard excisional surgery.STSGs consist of the epidermis and a small amount of the underlying dermis, and they are classified according to their thickness. STSG has advantages compared with full‐thickness skin graft (FTSG), including reduced metabolic demand, and therefore have an increased chance of graft take. They can thus be used to give coverage to large wounds, particularly those that do not have a robust vascular base. STSGs may be meshed to enable large surface area coverage and to allow the drainage of blood and exudates underneath the graft.The score and shave technique involves marking the donor site to the size of the STSG required with a surgical marker pen. The donor site is then injected with local anaesthetic. A no. 15 blade on a scalpel handle is used to score the perimeter of the graft to the appropriate level of the dermis (Fig.
Clinical & Experimental Dermatology – Wiley
Published: Jan 1, 2018
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