Meshed skin grafts placed upside down can take if desiccation is prevented

Baraa Zuhaili, Pejman Aflaki, Taro Koyama, Magdalena Fossum, Richard Reish, Birgitta Schmidt, Bohdan Pomahac, Elof Eriksson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: The role of the wet environment in wound healing has been investigated in various studies. The current study explores the role of the wet wound environment in promoting healing of skin grafts. The authors hypothesized that the survival of skin grafts is dependent not only on the orientation of transplantation but also on the environment into which the skin is transplanted. Methods: This study included 72 full-thickness (2.5 × 2.5-cm) wounds in six Yorkshire pigs. The wounds were grafted with autologous split-thickness skin grafts (meshed or sheet), placed either regularly (dermal side down) or inverted (dermal side up), and treated in a wet or a dry environment. Behavior of the skin grafts and healing were analyzed in histologic specimens collected on days 4, 6, 9, and 12 after wounding. Wound contraction was quantified by photoplanimetry. Results: In the wet environment, not only did inverted meshed skin grafts survive, but also they proliferated to accelerate reepithelialization. In this environment, wounds transplanted with inverted and regular meshed grafts showed no significant difference in reepithelialization rate and contraction. In contrast, in the dry environment, wounds transplanted with inverted meshed grafts showed a significantly lower reepithelialization rate and a higher contraction rate than wounds transplanted with regular grafts. Inverted meshed grafts in a dry environment and inverted sheet grafts did not survive. Conclusion: The wound environment has an important role in the survival and proliferation of skin grafts, as demonstrated by survival of inverted meshed grafts in the wet environment and their contribution to accelerated reepithelialization, equal to the regularly placed grafts.

Original languageEnglish (US)
Pages (from-to)855-865
Number of pages11
JournalPlastic and reconstructive surgery
Issue number3
StatePublished - Mar 2010
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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