Over Grafting Donor site

Tanner first described mesh grafting in 1964. He demonstrated the significant benefits with respect to increased recipient area coverage with consequently reduced donor site requirement, reduced operative time, and enhanced graft take due to the lack of fluid accumulation1. Inherent in the practice of skin grafting is the creation of a donor site. It is this area that is the source of the majority of postoperative pain and prolongs recovery. Optimal management of donor sites remains controversial, and as a result a vast array of dressings are available for coverage and a number of techniques, and even complete exposure to the atmosphere, have been proposed. Thompson et al2demonstrated that donor sites may be covered by a split skin graft with significant improvements in both healing time and the quality of the donor site. The donor area not covered by skin regenerates and resurfaces itself by secondary epithelialisation, assuming that the donor site retains sufficient dermis to replace the epidermis. When more than two thirds of the dermis is taken there is a significantly higher incidence of delayed wound healing, hypertrophic scarring and deranged pigmentation.