Purpose: The purpose of our study was to compare the healing characteristic
s of two common techniques of obtaining a dermal graft and the patient's pe
rception of the aesthetics of the donor site scar.
Materials and Methods: Fifty-two female patients (60 sites) were evaluated
by means of questionnaire, interview, and chart review. The mean follow-up
time was 4.08 years after temporomandibular joint reconstructive surgery. C
omparisons were made between the two primary harvest techniques: the dermat
ome (trapdoor) and the elliptical excision methods. Of the 60 sites, 32 inv
olved the elliptical method and 28 the trapdoor method.
Results: Common findings in both groups included prolonged discomfort (6.6%
), altered contour (50%), color change (58.3%), prolonged numbness (10%), a
nd itching (21.6%). There were few healing complications (5.0%). Aesthetica
lly 45% of patients thought their scars were noticeable, and 8.3% thought t
hat they were bothersome. The elliptical method showed significantly less d
iscomfort, texture change, numbness, and itching. The scars were concealed
better and less noticeable. Although 60.7% of the patients with the trapdoo
r method considered the wounds to be noticeable, only four patients reporte
d that the scars were bothersome.
Conclusions: Both techniques were used successfully with minimal complicati
ons. Although the elliptical technique appeared to have cosmetic advantages
, larger grafts produced longer wounds, which may be more difficult to conc
eal. The trapdoor method is a simple technique that is used effectively wit
h good patient acceptance. The results of this study are useful in properly
informing patients about what to expect after having a dermal graft.