title: [Clinical study of full-thickness skin graft for reconstruction of completely defect nail unit].
abstract: OBJECTIVE
  To explore a reconstruction method for complete nail bed defect caused by various kinds of reasons and to retrospectively analyze the  effect of application of free full-thickness skin graft for the whole nail unit repair.
  
  
  METHODS
  Between Apr. 2010 and Mar. 2012, the method of free full-thickness skin graft was done for reconstruction of the completely nail unit defect in seven cases. There were 2 male and 5 female patients; the mean age  of these patients at the time of surgery was 51.9 years (range: 7 to 70 years). The preoperative diagnoses included two cases of malignant melanoma,  one of chronic infection, one of squamous cell carcinoma, two of subungual pigmentation and one of junctional nevus. There were 2 thumb lesions, 3  middle and 2 index finger lesions. Nail unit defect was in the range of 1.5 cm×2 cm to 2.5 cm × 3.5 cm and full thickness skin graft was harvested from the  same medial side of upper arm (3 cases), forearm cubital fossa (1 case) and contralateral side of groin region (3 cases).
  
  
  RESULTS
  All the patients were  followed with an average follow-up time being 10 months. All the free skin graft taken was achieved with 100% in all the 7 cases, even in those patients  whose partial cortical bone had been curetted. The skin graft was often bluish initially, and superficial blisters were always noticed within 1.5 months  postoperatively and the survival skin graft was smooth eventually, and skin graft was adhered to the underlying bone tightly. There was no epidermal  inclusion cyst and no residual nail formation. The skin donor sites were without complications. Aesthetic appearance was assessed by the surgeons and  found no unacceptable for their patients. And all the patients were satisfied with the cosmetic appearance and active range of motion of their involved  fingers, who did not express a desire to undergo any further of nail reconstruction.
  
  
  CONCLUSIONS
  Free full-thickness skin grafting for reconstruction of the  complete nail unit defect is a simple, safe and effective procedure which provides a satisfactory aesthetic appearance and does not make any significant  skin donor site morbidity especially for middle-aged and elder patients.
authors.affiliation: Department of the Hand Surgery, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Wen-jun
authors.initials: WJ
authors.lastname: Li
authors.forename: Chun
authors.initials: C
authors.lastname: Li
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
authors.forename: Guang-lei
authors.initials: GL
authors.lastname: Tian
authors.forename: Shan-lin
authors.initials: SL
authors.lastname: Chen
authors.forename: Wen
authors.initials: W
authors.lastname: Tian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D055815:Young Adult