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A novel technique for getting mini thin Thiersch’s skin grafts for tiny vitiligo lesions
*Corresponding author: Muhammed Mukhtar, Consultant Dermatologist, Mukhtar Skin Centre, Katihar Medical College Road, Katihar, Bihar, India. drmmukhtar20@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Mukhtar M. A novel technique for getting mini thin Thiersch’s skin grafts for tiny vitiligo lesions. CosmoDerma 2022;2:106.
PROBLEM
Thin Thiersch’s skin grafting is used for treating stable vitiligo.[1,2] For better cosmetic outcomes, we need practice and appropriate hand balance while using dermatome to get a thin skin graft. However, because of the large size of the dermatome, the grafts are not always as thin as we require. Furthermore, because of the size of the dermatome, it is difficult to get small grafts for tiny lesions.
SOLUTION
We used a customized and modified razor blade and a cut syringe barrel as its handle to overcome the challenges of obtaining a tiny thin skin graft. First, the recipient site is prepared with a dermabrader, customized blade or biopsy punch. Two mini thin skin grafts are then taken from the neighboring naturally pigmented skin using the blade device in the first sitting. Grafts are gathered in the blade device once they have been harvested. These two grafts are applied over the recipient site by dragging them from the device using a hypodermic needle. These grafted areas will show pigment spots after 10 days [Figure 1a-c]. In second sitting, the customized blade and biopsy punch(5 to 8 mm) both have been used for taking the grafts, preparing the recipient site and grafting them over the remaining part of the same lesion [Figure 1d-f]. The blade is sharper so it is easier to harvest the mini-thin skin graft with blade as compared to the biopsy punch. As a consequence, the customized device may be a good novel option for treating small residual vitiligo lesions with mini-thin Thiersch’s skin grafts. However, precautionary measures should be taken when obtaining the grafts. First, the skin must be well stretched. Second, with stretched skin, blade edge alignment would be tangential. Third, the instrument is steadily pushed forward with slight rotating or twisting movement to harvest the graft.
- (a-f) Two tiny thin Thiersch’s skin grafts were harvested and transplanted over the recipient site in the first sitting showing two pigment spots after 10 days (a-c), and the rest of the lesion is treated in the second sitting using the customized device and biopsy punch (d-f).
Declaration of patient consent
Patient’s consent not required as patients identity is not disclosed or compromised.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- Repigmentation of poliosis after epithelial grafting for vitiligo. Dermatol Surg. 2013;39:406-11.
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