Immediate Regrafting of Over-Harvested Skin at Donor Sites for Split-Thickness Skin Grafting in Elderly Patients

Background: The complication of donor site in skin grafting often acts as a causing factor for extended treatment period. The elderly individuals tend to be afflicted by impaired wound healing. Herein, we presented the outcome of skin regrafting in the elderly patients. Methods: Patients who aging over 60 had anterior thigh split-thickness skin grafting (STSG) donor sites as part of any reconstructive surgery were included. In experimental group, the over-harvest skin back was replaced on the donor site in island type, and Alleyvn (Smith & Nephew) was put upon the regrafting skin as fixation. In the control group, the donor site was only covered by Alleyvn (Smith & Nephew). Variables extracted included demographics, intra-operative data and post-operative outcomes. Vancouver scar scale (VSS) was used to evaluate scar condition in donor site in post-operative 3 months. Results: Twenty-six patients with 15 re-grafting versus 11 non-regrafting were analyzed. There was a significantly shorter in the healing time of donor site in the re-grafting group than the non regrafting group (28.33 vs. 39.91, p = 0.03). All the parameters of VSS were significant difference between regrafting versus non-regrafting groups, for the mean scores of vascularity (0.36 ± 0.34 vs. 1.64 ± 0.61, p < 0.01), pigmentation (0.52 ± 0.31 vs. 1.98 ± 0.44, p < 0.01), pliability (0.48 ± 0.26 vs. 1.49 ± 0.51, p < 0.01), height (0.23 ± 0.20 vs. 0.98 ± 0.39, p < 0.01). Conclusions: Compared with artificial dressing only, immediate regrafting of over-harvest skin on the donor site in STSG is a reliable method to provide faster healing time and better scar formation in the elderly.