Exploring the potential of dermal grafting: a narrative review in plastic surgery

Abstract

Dermal grafting (DG) has emerged as an innovative technique in plastic and reconstructive surgery, offering several advantages over traditional skin grafting methods. This review provides an in-depth exploration of DG, highlighting its applications, benefits, and future directions. The historical evolution of skin grafting is discussed, tracing the development of DG as a novel approach to address the limitations of conventional techniques. The review focuses on four key advantages of DG: (1) accelerated healing of donor sites; (2) improved aesthetic outcomes at recipient sites due to the elastic nature of dermal grafts; (3) increased graft availability by effectively at least doubling the amount of graft material obtained from a single donor site; and (4) utility in scar revision and reconstruction procedures, particularly in areas with restrictive scarring or contractures. Recent advancements, such as the development of a multiblade dermatome, have addressed the technical challenges associated with DG harvesting, potentially broadening the clinical adoption of this technique. Preliminary results from studies utilizing this new device have demonstrated its feasibility in producing dual grafts (split-thickness skin graft and dermal graft) concurrently, simplifying the surgical procedure. The review also explores future directions in DG, including further refinements to the multiblade dermatome, and clinical trials to validate long-term benefits. Overall, this review highlights the significant advantages of DG and its potential in advancements of plastic and reconstructive surgery, ultimately improving patient outcomes and quality of life.