25.0: Thursday, March 17, 2005

Glabrous Dermal Grafting: A 12 Year Experience with the Functional and Aesthetic Restoration of Palmar and Plantar Skin Defects

Liza C. Wu, MD and Lawrence J. Gottlieb, MD.

Background: Glabrous skin on the palm, fingers, and sole has special attributes that make it different than hair-bearing skin. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. We report our 12 year experience with the technique of glabrous dermal grafting for the reconstruction of palmar and plantar skin defects. Methods: From 1992 to 2004, thirteen patients with 14 defects underwent glabrous dermal grafting of palmar or plantar defects. Defects included 9 hand and 5 foot defects. Etiologies included 9 burns, 1 secondary burn reconstruction, 2 traumatic injuries, 1 congenital nevus, and 1 melanoma. Donor sites included 12 from the foot and 2 from the hand. Results: Follow up ranged from 1 to 65 months. All glabrous dermal grafts demonstrated epithelialization and no partial or complete loss. There was return of sensation without hyperkeratosis or breakdown. The grafts demonstrated color matching the surrounding skin. The donor site healed without complications, and there were no incidences of hypopigmentation, hyperpigmentation, or hypertrophic scarring. Conclusions: Glabrous dermal grafting of palmar and plantar defects is the ideal way to reconstruct glabrous skin to restore function and aesthetics and minimize donor sight morbidity.