A New Alternative to Produce Meshed Skin Graft with Manual Fold and Cut Technique: A Case Series
Areska Ramadhan1, Akhmad Noviandi Syarif1, 1Surgery Department, Plastic Reconstructive and Aesthetic Surgery Division Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, DKI Jakarta, Indonesia
Abstract
Background: Meshed skin graft has become the standard for raw surface coverage in burn patients. However, the Mesher tools are not widely distributed to some health facilities worldwide. Therefore, the authors developed manual folding and scissor technique inspired by making meshed paper for faster wound closure.
Method: This case series aimed to evaluate the wound closure of patients who received meshed graft produced with manual fold and cut technique. This technique was done by folding skin graft on a sterile paper scaffold and cutting it manually using scissors in a criss-cross pattern with certain intervals. The resulting meshed graft then expanded and set to the raw surface. Burn patients who underwent the procedure in Cipto Mangunkusumo Hospital since 2022 are followed and reported for the day of epithelization, graft take, and complications.
Result: Manual fold and cut technique was applied in four patients with burn injuries. This technique allowed skin graft expansion up to 1.9 times. Epithelization was mainly achieved within 14-26 days, and graft takes were ranging from 90-100% in all four patients. No complication was reported in all patients.
Conclusion: Manual fold and cut technique showed excellent results in all four patients. This technique can be done repeatedly as the procedure is rapid, reliable, and gives promising outcomes. This technique can be proposed to all health facilities that do not have access to the Mesher tool.
Keywords: Meshed, Skin, Graft, Fold, Burn
Biography
Areska Ramadhan is an Indonesian Medical Doctor, who was graduated from a double degree program in University of Melbourne and Universitas Indonesia. He’s been active presenting his research on craniomaxillo-facial and burns in his home country or abroad. dr. Areska is currently doing residency program in Plastic Reconstructive and Aesthetic Surgery in Cipto Mangungkusumo General Hospital / Universitas Indonesia.