Skin Harvesting on the Scalp in Children: Utopia or Reality

Abstract

Skin harvesting from the scalp in children can be recommended as first choice. The advantages, especially the rapid epithelialisation and the lack of visible scars, overcome the problems and the risks.

Ten years later – scalp still a primary donor site in children

“…Because of rapid healing in comparison to other donor sites, there is a possibility of re-harvesting the scalp after a relatively short time (6-14 days) [2,4,11,13,15]. In our material in all children the donor site healed between the 7th and 10th postoperative day.…”

“…Many areas have been used in children including buttocks, thighs, upper arms, abdomen, scrotum, soles, etc. but scalp appears to be superior as a donor site as proven by many leading pediatric burn centers [1][2][3][4][5][6].…”

“…Following the experience of others, although presented in a limited number of publications [1,[4][5][6]8,[10][11][12][13]16,18,19], in conjunction with our own dissatisfaction when using alternative donor sites, we decided to select the scalp to be the primary donor site for our patients. We also decided to introduce early contact therapy for scar therapy/prevention.…”

The scalp as a donor site for skin grafting in burns: retrospective study on complications

“…The scalp as a donor site is less common, while it is considered a reliable donor site since its first use in 1964 [ 1 ]. The advantages are less painful compared to other donor sites [ 2 – 4 ], cosmetically favourable results as the re-growth of hair conceals the donor site [ 3 – 8 ] and a relatively large surface area when applied in children [ 5 , 8 ]. Other reported advantages are the faster epithelialisation of the scalp [ 9 ] and good colour matching [ 10 ] with the skin of the face.…”

“…The faster epithelialisation is due to the high amount of dermal appendages—and thus, a substantial supply of follicular epithelial stem cells—and the scalp’s rich vascularity [ 3 , 4 , 6 , 7 , 9 ]. This allows for multiple harvests from the same site [ 3 , 5 – 7 , 9 , 11 , 12 ]. The good colour matching with the face makes the scalp an ideal donor site when treating facial burns [ 3 – 7 , 10 ].…”