title: Reepithelialization from stem cells of hair follicles of dermal graft of the scalp in acute treatment of third-degree burns:  first clinical and histologic study.
abstract: BACKGROUND
  The scalp, an excellent donor site for thin skin grafts, presents a limited surface but is rich in keratinocyte stem cells. The purpose of this study was to double scalp harvesting in one procedure and to evaluate the capacity of the dermal layer to spontaneously reepithelialize from hair follicle stem cells.
  
  
  METHODS
  Two layers of 0.2-mm split-thickness skin graft, a dermoepidermal graft and a dermal graft, were harvested from scalp during the same procedure. Fifteen burn patients were included in this study. Healing of the scalp donor site and percentage of graft taken were evaluated. The Vancouver Scar Scale was used at 3 months and 1 year. Histologic studies were performed at day 0 and 3 months on grafts, and on the scalp at day 28.
  
  
  RESULTS
  Nine patients were treated on the limbs with meshed dermal graft. Six were treated on the hands with unmeshed dermal graft. Graft take was good for both types of grafts. The mean time for scalp healing was 9.3 days. Histologic study confirmed that the second layer was a dermal graft with numerous annexes and that, at 3 months, the dermis had normal thickness but with rarer and smaller epidermal crests than dermal graft. The difference between the mean Vancouver Scar Scale score of dermal graft and dermoepidermal graft was not significant.
  
  
  CONCLUSIONS
  The authors' study shows the efficacy of dermal graft from the scalp and good scalp healing.
  
  
  METHODS
  Therapeutic, II.
authors: Tours and Paris, France Hopital Trousseau, Centre Hospitalier Régional et Universitaire de Tours; and Hôpital Saint Louis, AP-HP, UFR Médecine Paris 7 Denis Diderot.
authors: Gilbert
authors: G
authors: Zakine
authors: Maurice
authors: M
authors: Mimoun
authors: Julien
authors: J
authors: Pham
authors: Marc
authors: M
authors: Chaouat
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002056:Burns / Q000473:pathology / Q000601:surgery*; D020405:Dermis / Q000637:transplantation; D004817:Epidermis / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D018859:Hair Follicle / Q000166:cytology* / Q000637:transplantation; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D012535:Scalp / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D012867:Skin / Q000473:pathology; D016038:Skin Transplantation; D033581:Stem Cell Transplantation / Q000379:methods*; D013234:Stem Cells / Q000166:cytology*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014945:Wound Healing