Skin graft meshing, over-meshing and cross-meshing

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Skin graft meshing, over-meshing and cross-meshing James Henderson, Reza Arya, Patrick Gillespie International Journal of Surgery Volume 10, Issue 9, Pages 547-550 (January 2012) DOI: 10.1016/j.ijsu.2012.08.013 Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 1 Four cm square split porcine skin graft marked for orientation before being meshed. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 2 Single mesh 1:3 expanded. Note that the graft narrows in the centre when stretched out. The graft area expands 1.80×. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 3 Micro (sideways) and then 1:1.5 overmeshed skin graft. A few sideways-meshed areas can be seen. The graft area expands 1.50×. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 4 1:1.5 then 1:1.5 overmeshed skin graft. Note the pattern of expansion is different to that seen with a singly-meshed graft. The graft area expands 1.81×. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 5 1:1.5 and then 1:3 overmeshed skin graft. Note that the pattern of meshing is different to that seen with a singly-meshed graft. The graft area expands 2.3×. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 6 1:3 and then 1:3 overmeshed skin grafting leads to unusable strands of skin. We caution against this pattern of overmeshing. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions

Fig. 7 Care must be taken to avoid passing the skin through the mesher for a second pass at 90° to the primary mesh, as this cuts the graft into small fragments unusable for conventional grafting. International Journal of Surgery 2012 10, 547-550DOI: (10.1016/j.ijsu.2012.08.013) Copyright © 2012 Surgical Associates Ltd Terms and Conditions