Journal of Clinical and Experimental Transplantation
Open Access

The history of split- consistence skin grafting dates back to the late 19th century. The foremost known split- consistence skin grafting system was developed by Ollier in 1872. His results revealed not only a briskly mending but also lower scar conformation and thus lower scar contractures by covering the whole crack face with skin grafts. Since these grafts included epidermis as well corridor of the dermis, Ollier called his fashion “dermo-epidermic grafting”. Prof. Carl Thiersch, president of the surgery department in Leipzig, presented his fashion at the 15th Congress of German Surgical Association in 1886. His fashion advised to cut the skin with a razor blade as thin as possible via sharp vertical lacerations to produce thin strips of epidermis, only including small corridor of dermis. Thiersch’s fashion attained public hype, which is known as “Thiersch Graft”. Caused by the similarity of both discoveries, the system is also known as “Ollier – Thiersch graft”. In 1929, Blair and Brown presented their system of “disunited skin grafts” of intermediate consistence. These grafts differ from “Ollier–Thiersch graft” in regard of the consistence due to included layers of dermis. While Ollier and Thiersch advised to include only little further than the epithelial subcaste, the split skin grafts of intermediate consistence also included a perceptible quantum of the dermal subcaste. The idea was to save the advantages of both, the “Ollier–Thiersch graft”, as well those of the full- consistence skin graft. In 1941, Earl. Padgett, an American surgeon, developed a new system of split- consistence skin grafting by using a homemade dermatome. The “Three-quarter”- consistence skin graft demonstrated good graft take, and the dermatome enabled the possibility of new skin patron spots, which weren’t available by free hand skin grafting styles.

Distance Graft

Distance grafting is considered to be the gold standard for the treatment of small becks and to cover sensitive areas. Distance grafts accelerate the end of the seditious phase and offer a better vascularization andre-innervation. Farther benefits are the lower tendency for scar conformation and contractures, a better aesthetic outgrowth, and no endless mesh pattern in discrepancy to meshed skin grafts. Thus, distance grafts are applicable to cover visible and functionally important areas. Distance grafts can as well be used to cover aesthetic and functional important areas in severe becks, in order to save patron spots rather of original content with full- consistence skin grafts. The disadvantages of distance grafting are the need of larger patron spots, the threat of hematoma conformation, the peril of losing the graft because of its impermeability, and the incapability to cover severe becks, which is caused by a lack of patron spots.

Mesh Graft

Professor Otto Lanz was displeased with the fact that the patron point of a Thiersch graft was still an open crack, while the original disfigurement formerly healed. He delved colorful styles, but none of the trials led to a satisfactory result. Due to a nonage game, which was used to make a paper accordion, he was encouraged to use the same system for skin grafting. Lanz developed an accordion-suchlike expansion of a Thiersch graft in 1908, which not only served the purpose of covering the disfigurement but also the recently formed crack of the patron point.

In 1964, James C. Tanner, a plastic surgeon at the Long Memorial Hospital, Atlanta developed a new system to produce expanded STSGs by operation of a new device named “Tanner–Vandeput mesh dermatome”. By rolling split- consistence skin grafts through the new dermatome, the machine cuts the skin grafts into a mesh with lists of skin0.050- elevation wide. Tanner’s mesh grafting enabled skin grafts expanding up to a rate 13, reducing the area of the patron point and offering the possibility of covering further crack area. Currently, rates up to 16 or indeed 19 are possible by using special bias. Complete crack content can be achieved in roughly 10 days through rapid-fire epithelialization in the absence of infection. Likewise, drainage of exudate and hemorrhage, as well recovering of areas lost by shrink is possible, due to the mesh-suchlike structures.

Meek Fashion

In 1958 Cicero Parker Meek, a general guru at the Aiken Country Hospital in South Carolina known for his great interest in burn care, published an composition called “Successful Microdermagrafing using the Meek–Wall microdermatome”. The Meek – Wall microdermatome comported of 13 blades driven by an electronic machine. Flat cork plates served as carriers for the skin grafts. The functions were described by a case report of a 14- time-old burn victim with 25 total body face area. Meek cut conventional split- consistence skin grafts (0.0125 elevations) into units1/16 elevation square (40 mm²). Latterly, the microdermagrafts were impregnated in tube and unevenly distributed to prefold parachute silk tapes, which were placed directly on the crack. After ten days, the grafted areas could be left exposed.