Split-skin grafting from the scalp: the hidden advantage.

BACKGROUND Split-skin grafting is a routine reconstructive technique associated with large variation in practice. Grafts from the thigh, buttock, or abdomen take a long time to heal and may leave unpleasant, hypopigmented scars. Retrospective reports favor the scalp as a donor site in burn patients. OBJECTIVE Evaluation of duration of healing, cosmetic outcome, and safety of split-skin grafting from the scalp in patients receiving dermatologic surgery. MATERIAL AND METHODS One hundred sixty-six consecutive patients (85 men, 81 women) were treated for coverage of chronic leg ulcers or other large skin defects with a split-skin graft taken from the posterior scalp. Area and thickness of the graft, healing time, and adverse events were documented. RESULTS Mean healing time until complete reepithelization was 5.4±1.0 days for a single harvest (median 5 days). No major complications occurred. Spotted alopecia was a rare event. Almost all (96.5%) of the patients would undergo split-skin harvesting from the occipital scalp again if needed. CONCLUSIONS Advantages of the scalp as a donor site include rapidity of wound healing, low risk of complications, and excellent cosmetic results. The large number of hair follicles containing the epidermal stem cell pool can explain these advantages.