Progress in Microdermal Grafting for Color Regeneration of White Scars. (31st July 2021)

• Record Type: Journal Article
• Authors: Tsao, Su-Ben; Jong, Lih-Ren; Su, Yue-Chiu; Kuo, Yur-Ren
• Is Part Of: Aesthetic surgery journal. Volume 41:Number 11(2021)
• Page Start: NP1758
• Page End: NP1768
• Publication Date: 2021-07-31
• Subjects: Surgery, Plastic -- Periodicals; 617.95
• DOI: 10.1093/asj/sjab301
• Languages: English
• ISSNs: 1090-820X

Abstract

Abstract: Background: Microdermal grafting with knife-cut, partially de-epithelialized skin can regenerate color in white (hypopigmented) scars. However, the scalp has more melanocytes, and dermabrasion can preserve more melanocytes than knife cutting during partial de-epithelialization. Objectives: The aim of this study was to evaluate the color regeneration results and complications of various microdermal grafting procedures for white scar color regeneration. Methods: Two refinements to an existing microdermal grafting technique for treating white scars were described: dermabrasion, rather than knife cutting, was used to partially de-epithelialize skin, and melanocyte donor sites were harvested from the scalp, rather than from skin. A review was performed of 65 cases in which various combinations of these refinements were used to treat scars on the face and forearms. Results: Sixty-five patients (36 forearms; 29 faces) were treated, 40 receiving 1 session, 23 receiving 2 sessions, and 2 receiving 3 sessions of treatment. The follow-up was 6.5 months (range, 4-16 months). The use of both technique refinements produced approximately 15% better color generation than the original procedure after 1 session of treatment and approximately 20% better than the original procedure after 2 sessions. Histologic immunostaining showed that the dermabrasion method preserved more melanocytes around the epidermal-dermal region, and that the scalp has richer melanocytes than skin. The complication rate was reduced. Conclusions: The use of the scalp as the donor site and partial de-epithelialization by dermabrasion can be safely incorporated into a previously developed microdermal grafting procedure for better color regeneration of white scars. Level of Evidence: 4: