“A Little Skin in the Game”: Full Thickness Skin Grafting in Pediatric Orthopaedic Surgery Surgical/Technical Tips

Abstract

Congenital orthopaedic anomalies and acquired pediatric wounds of the extremities frequently require reconstruction of the soft tissue envelope. In many of these circumstances, full-thickness skin grafting (FTSG) is a reliable and appropriate reconstructive option. However, FTSG harvest is rarely discussed in the orthopaedic literature. We present a reliable and reproducible method of full-thickness skin grafting that is easily performed. In this technique, we harvest a full-thickness skin graft from the lower abdomen using a symmetric transverse midline suprapubic incision (i.e., Pfannenstiel incision). This donor site allows for abundant skin graft harvest while providing a concealed location and the potential for additional graft harvest. Finally, we discuss the critical importance of postoperative recipient site dressings to optimize skin graft take.