THE FINGER AS A DONOR SITE FOR SKIN GRAFTS

By IVAN PAKIAM, F.R.C.S.(C)., F.A.C.S1

Deer Lodge Veterans Hospital, Winnipeg, Canada

WHILE treating a finger-tip injury which required a skin graft, it occurred to me to take the graft from the same finger. It was already anaesthetised and prepared. Since then this method has been used in more than 400 patients over a 4-year period; the youngest patient was 5 years of age, the oldest in his seventies.

The donor scars have been followed up for a year in all cases; it was found that they become inconspicuous after a few months. In I case where the donor site had become hypertrophic after taking a thick split-skin graft, the scar took a year to settle. No scar tenderness was encountered.

FIG. I. The donor sites are the inner aspects of the fingers avoiding the outer sides of the index and little.

FIG. 2. A split-skin graft being cut with a No. 20 scalpel blade held between finger and thumb without a handle.

FIG. 3. The split-skin graft tacked over the raw area.

FIG. 4. The scars I year later.

r Present address: Suite 306, West Towers Building, 1200,35th Street, West Des Moines, Iowa 50265, USA.

32

THE FINGER AS A DONOR SITE FOR SKIN GRAFTS 33

Technique. The donor sites are the sides of the fingers near the webs as shown in Figure I. Either or both sides may be used in most fingers but one should avoid the ulnar side of the little finger and the radial side of the index.

Split skin grafts. These are taken with a number 20, 21 or 22 scalpel blade held between the thumb and index finger. No handle is used and better control is thereby obtained. The edge of the blade is angled at 40 degrees to the skin surface and the action is a gentle sawing motion. With experience and by varying the angle of the blade, grafts of varying thicknesses and sizes can be obtained (Figs. 2-4).

Full-thickness skin grafts. These are cut to a pattern as they would be elsewhere and the defect is covered with a split-skin graft cut as above from the other side of the finger.

My thanks are due to Mr R. Moore and Mr D. Pennev for their ?lelp with the photographs and to 1q wife for her help with the manuscript.

311-c