Page 56 - Read Online

Sjöberg et al. Plast Aesthet Res 2024;11:55 https://dx.doi.org/10.20517/2347-9264.2024.86 Page 5 of 7

obstacles, potentially broadening the usage of dermal grafting techniques.

Initial experiments with this device [Figure 1] (Patent, Reg. 2050787-7 and 21739981.5) on four human
cadavers demonstrated its capability to produce at least two distinct grafts with predetermined thicknesses,
simplifying what has typically been a complex and demanding surgical task. The thickness of the dermal
graft can be adjusted within the desired range by modifying the opening at the second cutting blade. As
shown in the paper, this adjustment enables the production of dermal grafts with thicknesses ranging from
200 to 1,000 µm. At the microscopic level, the uniformity of both the upper and lower grafts confirmed the
precision of the dermatome, and the ease of use was documented in parallel and thus supported its future
potential. This proof-of-concept study highlights the multiblade dermatome’s feasibility in producing dual
grafts, suggesting a future where dermal grafting could be more accessible and practical in clinical
[15]
settings .
Preliminary results utilizing this new device are promising. The multiblade dermatome allows for more
precise and consistent cuts, significantly reducing the technical difficulty of the procedure. This innovation
not only simplifies the harvesting process but also enhances the quality of the dermal grafts obtained,
leading to better integration and healing at the recipient site.

FUTURE WORK
One challenge that needs further exploration is the expansion level of the DG and its relationship with the
healing process. Another topic of interest is the choice of thickness for the DG component, where two issues
evolve. Firstly, there is a need for a thicker dermal component in the reconstruction of areas with restrictive
scars or contractures. Secondly, the multiblade dermatome can be adjusted to take different thicknesses of
the graft, and the choice of thickness needs to be explored, also from the point of creating a full-thickness
skin defect. The variability of the dermal component thickness needs to be included in the decision process,
as different body areas, such as the back, limb, and sole, provide dermal areas with varying thicknesses.
Additionally, the value of generating more than two strips with a multiblade dermatome needs to be further
explored.

Future work will also focus on further refining the multiblade dermatome to optimize its performance and
ease of use. Additionally, clinical trials are needed to validate the long-term benefits of using this device in
various reconstructive procedures. Researchers are also exploring the potential for combining the
multiblade dermatome with other advanced technologies, such as tissue engineering, to further enhance the
precision and efficiency of dermal grafting. These efforts aim to make dermal grafting more accessible and
practical for a wider range of clinical applications, ultimately improving patient outcomes in plastic and
reconstructive surgery.

SUMMARY
The review traces the historical development of skin grafting, leading to the introduction of dermal grafting
in the early 21st century as a novel approach to overcome the limitations of conventional techniques. Four
main advantages of dermal grafting are highlighted:

Accelerated healing at donor sites compared to conventional split-thickness grafts.

Improved aesthetic outcomes due to the elastic nature of dermal grafts, enabling application without
meshing for a smoother appearance.