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Page 4 of 7 Sjöberg et al. Plast Aesthet Res 2024;11:55 https://dx.doi.org/10.20517/2347-9264.2024.86

These challenges have hindered the implementation of the technique despite its evident advantages.

ADVANTAGES OF DERMAL GRAFTING IN PLASTIC AND RECONSTRUCTIVE SURGERY
Increased healing rate of donor sites
Dermal grafting has been shown to accelerate the healing process at donor sites compared to traditional
STSG. By harvesting both a STSG and a DG from the same donor site, and returning the STGS back to the
donor site, the donor site morbidity is minimized and recovery is faster and cosmetically better. This
technique minimizes donor site morbidity and promotes faster recovery. This dual-harvesting approach not
only enhances healing but also reduces the overall impact on the patient.

Improved aesthetic outcomes
One of the significant advantages of dermal grafts is their elasticity, which allows for better aesthetic
outcomes. Unlike meshed grafts, which leave a characteristic mesh pattern when expanded, dermal grafts
can be applied without meshing, resulting in a smoother and more natural appearance at the recipient site.
This is particularly beneficial in areas where aesthetics is crucial, such as the face and hands. Additionally,
the risk of secondary contracture is lower compared to that of regular STSGs, highlighting the significance
of dermal grafts in covering body areas with a higher risk of contractures, such as big joints and the neck
region.

Increased graft availability
Dermal grafting effectively doubles or triples the amount of graft material available from a single donor site.
By obtaining both a STSG and a DG simultaneously, surgeons can maximize the use of available donor sites,
reducing the need for additional donor areas and minimizing associated morbidity. This increased
availability is especially advantageous in cases involving extensive burns or large wound areas.

Utility in scar revision and reconstruction
Dermal grafts are particularly useful in the reconstruction of areas with restrictive scars or contractures. The
elastic nature of dermal grafts allows for improved mobility and range of motion in scarred areas,
potentially reducing the need for more extensive surgical interventions. Additionally, dermal grafts can be
combined with other reconstructive techniques, such as tissue expansion or flap procedures, to enhance
both aesthetic and functional outcomes.

In conclusion, dermal grafting represents a significant advancement in plastic and reconstructive surgery,
offering numerous potential benefits over traditional skin grafting methods. Its ability to accelerate donor
site healing, improve aesthetic outcomes at the recipient site, increase graft availability, and facilitate scar
revision and reconstruction makes it a valuable technique for modern surgical practice. However, one
limitation is that the above-mentioned advantages of the DG technique are currently supported by only
smaller case series, and further evidence is needed. Additionally, the technique requires refinement through
larger patient studies. As innovations such as the multiblade dermatome continue to evolve, the accessibility
and practicality of dermal grafting are expected to improve, further expanding its clinical applications.

PRELIMINARY RESULTS WITH A NEW MULTIBLADE DERMATOME AND FUTURE WORK
Recent advancements in dermal grafting technology have led to the development of a multiblade
dermatome, designed to address the technical challenges associated with harvesting dermal grafts using
traditional single-blade dermatomes. The study presented below describes the development and initial
application of a novel multiblade dermatome, designed to concurrently harvest a conventional STSG and a
DG within a single surgical procedure. Traditional methods of DG extraction have faced significant
technical challenges, limiting their clinical adoption. However, this new prototype aims to overcome these