COMPARATIVE STUDY OF PIGMENTARY CHANGE BETWEEN "SPLIT-THICKNESS" AND "FULL THICKNESS" SKIN GRAFTS

Abstract

Differences in skin coloration have enormous importance in final cosmetic result in skin grafting. This problem has not received as much attention as other aspects of skin replacement. The skin varies considerably in color among human races; even in the same person striking color variations occur between different areas of the body (inner upper limb, buttocks and face). If one treats only white Caucasians, this problem of color matching may not be so important. But most of the patients with dark skins as Negroes, darker-skinned Caucasian who has a great tendency toward pigmentation of their grafts [Revis, 2003].

According to Padgett when an area such as the face is to be grafted, the best results will be obtained if the selected donor area is nearly of the same thickness, texture, and color as that of the recipient site [Padgett, 1942]. Conway in 1956 referring to pigment variations in skin grafts, stated "In the human being, the successful whole thickness graft shows no variation in coloration from that which was exhibited in its original site." later in the same paper he adds "Furthermore, it is the rule rather than the exception, that whole thickness grafts in Negroes or in very dark- skinned Caucasians show an increased brown to black coloration after transplantation." this has been interpreted by some as an effect of the contraction under the graft, which results in a closer approximation of the melanin particles within it [Tsukada, 1974].

Melanin pigmentation as seen clinically in mammali_an skin reflects the melanin content of the keratinocytes, as once the melanin pigment formed, the pigmented granules can be transferred to other epidermal cells or to dermal phagocytes. The melanin in mammalian skin is