title: Fractional Skin Harvesting: Autologous Skin Grafting without Donor-site Morbidity.
abstract: BACKGROUND
  Conventional autologous skin grafts are associated with significant donor-site morbidity. This study was conducted to determine feasibility, safety, and efficacy of a new strategy for skin grafting based on harvesting small columns of full-thickness skin with minimal donor-site morbidity.
  
  
  METHODS
  The swine model was used for this study. Hundreds of full-thickness columns of skin tissue (~700 µm diameter) were harvested using a custom-made harvesting device, and then applied directly to excisional skin wounds. Healing in donor and graft sites was evaluated over 3 months by digital photographic measurement of wound size and blinded, computer-aided evaluation of histological features and compared with control wounds that healed by secondary intention or with conventional split-thickness skin grafts (STSG).
  
  
  RESULTS
  After harvesting hundreds of skin columns, the donor sites healed rapidly without scarring. These sites reepithelialized within days and were grossly and histologically indistinguishable from normal skin within 7 weeks. By contrast, STSG donor sites required 2 weeks for reepithelialization and retained scar-like characteristics in epidermal and dermal architecture throughout the experiment. Wounds grafted with skin columns resulted in accelerated reepithelialization compared with ungrafted wounds while avoiding the "fish-net" patterning caused by STSG.
  
  
  CONCLUSIONS
  Full-thickness columns of skin can be harvested in large quantities with negligible long-term donor-site morbidity, and these columns can be applied directly to skin wounds to enhance wound healing.
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Joshua
authors.initials: J
authors.lastname: Tam
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: William A
authors.initials: WA
authors.lastname: Farinelli
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Joel
authors.initials: J
authors.lastname: Jiménez-Lozano
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Walfre
authors.initials: W
authors.lastname: Franco
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Fernanda H
authors.initials: FH
authors.lastname: Sakamoto
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Cheung
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Martin
authors.initials: M
authors.lastname: Purschke
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: Apostolos G
authors.initials: AG
authors.lastname: Doukas
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Department of Dermatology, Harvard Medical School, Boston, Mass.
authors.forename: R Rox
authors.initials: RR
authors.lastname: Anderson