Benefits of Epidermal Harvesting for Wound Closure

The wound healing phase of epithelialization can last weeks to months.  A split-thickness skin graft (STSG) is another closure option.  However, it has several negative consequences: a second, often painful donor site wound¹, increased risk of infection² and scarring to both donor and grafted site³.  Case studies highlight an in-office procedure, epidermal harvesting (EH), which speeds healing and is less invasive (no surgery cost or risks).  Donor site wound is minimal, healing quickly.

#1:  16 y.o. male sustained metatarsal fractures while rock climbing leading to fracture blisters on dorsal foot.  Blisters were debrided exposing muscle and tendon.  After months of wound care (NPWT, matrix, HBOT), granulation tissue filled the defect with tendon still exposed.  Surgeon refused STSG with exposed tendon. The patient had severe pain and the donor site could add more.  EH was performed with minimal pain. Although the site harvested was smaller than the wound, cells migrated to cover the entire defect within weeks.

#2:  While hiking, 23 y.o. woman had a boulder fall, crushing her foot.  Surgeons tried desperately to save the foot but some toes were lost. The defect was slow to heal, frustrating this very active patient. The decision was made to use EH instead of STSG. Epithelial covered within 3 weeks. Donor site healed within a week.

#3:  56 y.o. diabetic woman with slow healing post-surgery foot wound. After months of wound care, granulation was complete, without epithelialization.  The patient refused STSG, not wanting another large non-healing wound; she chose EH. Both areas healed completely.

EH uses negative pressure and heat to harvest the epidermis into “microdomes” full of growth factors. These epidermal cells are transferred to the wound as an autologous graft.  This procedure, performed in less than an hour, can decrease pain and trauma, and shorten healing time for appropriately chosen patients.