Patterns of contraction in human full thickness skin grafts

It is taught that full thickness skin grafts contract minimally in humans. We aimed to examine this assumption. In a prospective study, a scale photograph of each of 54 human full thickne ss skin grafts was taken at operation once the graft had been inset, but be fore the application of any tie-over or other dressing. For 50 grafts, a su bsequent scale photograph was taken at follow-up (mean ill days post-operat ion). The photographs were digitised and the areas of the grafts recorded. Significant area reduction in human full thickness skin grafts was found (P < 0.01, mean area change -38%). Greater contraction was associated with in fection than without (P = 0.02, mean area change with infection -48%, witho ut infection -33%. Full thickness skin grafts applied to the peri-orbital a rea and nose contracted more than those applied to the scalp and temples (P = 0.002). No differences in contraction were found between donor sites, between metho ds of fixation, between males and females or between those taking no medica tion and those taking steroids or non-steroidal anti-inflammatory medicatio n. Area change did not correlate with initial graft area, patient age or ti me to second photograph. (C) 2000 The British Association of Plastic Surgeo ns.