57.9 Pinch grafts

These are little pieces of skin nipped off the donor area and put on a wound. The centre of a pinch graft is full thickness skin, but its circumference is epidermis only, so a pinch graft is a combination of a full thickness and a split skin graft. Pinch grafts are easy to cut, they resist infection well, and because they con tain some full thickness skin, they resist pressure better than a split skin graft; this makes them useful on the heel, or over the Achilles tendon. Pinch grafts have the disadvantage of making the donor site look ugly, unless you: (1) Make it look decorative and resemble tribial scarring. If so, explain that the graft will leave a scar and ask the patient what pattern he would like. (2) Excise the whole donor area in a strip of skin, as in H, Fig. 57-11.

Because pinch grafts are so easy to take, and need so little equipment, they are particularly useful in health centres. Experienced surgeons rarely use them. Unless it is important for a graft to wear well, split skin is better.