A simple turnover technique to harvest skin graft from the avulsed skin.

A 12-year-old child presented to us with an avulsion injury left lower limb 6 hours following road traffic accident. On examination, the patient had avulsion of skin from the anterolateral surface of the thigh and circumferential skin avulsion extending from knee joint to the foot (figure 1). The non-viable avulsed skin was debrided till the fresh bleeding edges were obtained. The avulsed skin was cleaned, and gross defatting was performed with a surgical blade and curved Metzenbaum scissors in a turnover fashion (dermal side facing above and epidermis side facing below). Once the thick layer of fat was removed from the avulsed skin, it was placed over a rolled sheet so that the skin can be stretched with multiple artery forceps (figure 2). The retained fatty later after gross defatting is excised with a Humby skin graft knife (figure 2). In our patient, a thin layer of dermis was also removed so that thick split thickness graft was obtained. Dermis component may not be removed if a full thickness graft harvest is intended. The harvested graft was placed over the thigh and leg in the same setting. In the second stage, leftover areas were covered and split thickness skin grafts were harvested from opposite thigh. The initial skin graft take was around 90% when evaluated at 2 weeks (figure 3); however, on the follow-up visit A simple turnover technique to harvest skin graft from the avulsed skin Ravikiran Naalla, Maneesh Singhal Images in...