Transplantation of the reversed dermis from skin leading to repair of the buccal mucosal epithelium.
Skin grafting or mucosal grafting has been widely applied as the established method to compensate mucosal defects. However, in the grafted skin the epidermis never transformed into the mucosal epithelium; the original nature of the transplant was maintained as skin. The available donor of mucosa is also strictly limited. Therefore, an improvement in method has been much needed in the field of oral surgery. We tried to transplant the dermis freed completely from the epidermis instead of the full-thickness skin, and succeeded in compensation of the mucosal defect. The defects of the buccal mucosa in 30 dogs were repaired, one side with reversed dermis graft (RDG) in which the dermis was turned inside out and sutured onto the bed. On the other side, the ordinary free full-thickness skin graft (FTSG) was carried out as a control. Comparative clinical and histological observations were conducted to analyze the healing processes. In RDG the graft was covered by the surrounding mucosal epithelium to form the mucosal tissue, while the implanted tissue inhibited the wound constricture. Histological examination revealed that the epithelial elements underwent degeneration, presumably through being embedded by the grafting of the dermis inside out. The epithelium covering the dermis graft seems to be nothing but normal oral mucosal epithelium.
D000818:Animals; D002610:Cheek; D004285:Dogs; D004848:Epithelium; D009061:Mouth Mucosa / Q000601:surgery* / Q000648:ultrastructure; D016038:Skin Transplantation; D014945:Wound Healing