Full Thickness Skin Graft (FTSG)

Abstract

Falabella also introduced the autologous miniature punch graft technique in 1978. 1 In this procedure, punch grafts (of 1. 0–1. 2 mm diameter) are taken from donor areas over the thighs, buttocks, postauricular areas or the medial aspect of the upper arm. These are grafted into recipient sites in the sockets created by using punches 1. 0 mm in diameter. To ensure a better fit, recipient punches are generally smaller by 0. 2 mm than donor punches. Smaller sized grafts are used to yield better cosmetic results (Figs. 7. 1–7. 11). Sockets are created in the recipient area (RA) at a distance of 5–10 mm and the harvested grafts are placed in these sockets. This allows the perigraft spread of pigment to cover the surrounding depigmented skin, the extent of which varies according to the skin color and site of the treated patch (more on exposed sites). After autologous miniature punch grafting, a remarkable repigmentation was obtained in 80% cases with 90–100% improvement. About 40–60% repigmentation was observed within 3–6 months in the majority (66. 6%) of cases and near total repigmentation was observed within 2 years. The maximum pigment spread (MPS) was observed over the face (cheeks) and neck, and the minimum repigmentation was observed over the left arm and right upper eyelid.²