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This study investigates the effects of culture grown fibroblasts on contraction and dermal regeneration when used concurrently with full-thickness skin graft (FTSG) in full-thickness wounds.Fourteen Sprague-Dawley male rats were divided into two groups. In the first group, wound contraction was evaluated visually. Two full thickness tissue defects were produced on the back of the seven rats. The skin harvested from these areas was prepared as a full-thickness graft and sutured back to their original beds. Just before the last suture, autogenous fibroblast suspension was applied between the graft and the bed in area 1, and area 2 served as control. The surface area of grafts were calculated and compared with "Image J" program. In the second group, contraction and dermal regeneration were evaluated histologically. Three full-thickness tissue defects were produced on the back of seven rats. Area 1 and 2 were prepared as described above and area 3 was left to secondary healing. On the 14th and 30th days, punch biopsies were harvested from the center of the areas 1-3. Preparations were examined under light microscopy.Wound contraction was significantly less in area 1 on day 14 (p0.01). Histologically neovascularization, fibroblast density and collagen synthesis were more evident in cultured fibroblast applied areas on day 14. However epithelialization did not show any difference between areas both on days 14 and 30. On day 30, area 1 still a higher degree of fibroblast intensity than the other areas but neovascularization and collagen synthesis were not different than the other areas.According to the data obtained from the study, cultured fibroblasts, particularly with a dermal support, do not regress when transplanted to a living tissue. They contribute to the wound healing process; reduce the contraction of the wound; and support collagen synthesis and neovascularization.

Background. Large defects not easily repaired with local flaps and defects near anatomic free margins or crossing anatomic units present unique challenges for reconstruction. Cosmetic results of full-thickness skin grafts may appear unsatisfactory owing to differences in color, texture, and thickness between donor and recipient sites. Objective. The objective was to describe a skin-graft reconstructive method that better approximates skin characteristics between donor and recipient sites while following other criteria to improve the final aesthetic and functional result. Methods. Careful evaluation of the tissue surrounding a surgical defect determines tissue laxity available for skin grafting and whether the defect crosses anatomic units or may distort anatomic free margins or landmarks. Through partial closure of the large surgical defect, preferably within cosmetic units, a tricone is created large enough to graft the remaining wound. Results. Creating smaller wounds within cosmetic units or subunits, there is less chance of distortion of nearby anatomic free margins or landmarks. Skin grafting is accomplished with tissue of similar color, texture, and thickness Conclusion. Adjacent-tissue skin grafts provide a suitable reconstruction option for surgical defects too large for simpler repair or defects crossing cosmetic units or near free margins. This procedure permits repair with a full-thickness skin graft of more similar skin characteristics to the recipient site.

Background. Reconstruction in the periorbital area is challenging owing to the complex function of the eye, relative lack of adjacent loose tissue, free anatomic margin, central facial location, and the need to maintain symmetry with the contralateral eye. Reconstructive options risk crossing anatomic margins, deviation of the lid margin (ectropion), persistent lymphedema, and repair with skin of dissimilar color, texture, and thickness. Objective. The purpose was to describe a reconstructive option that would avoid crossing cosmetic units or subunits, minimize the risk of ectropion, repair with tissue of similar surface characteristics, and maintain function and symmetry with the contralateral side. Methods. The adjacent-tissue skin graft provides closure in cosmetic units and subunits, avoids tension on the lid margin, and provides similar skin for repair. The procedure is demonstrated by graphic and photographic examples. Results. The procedure provides for esthetic repair of the periorbital area and minimizes the risk of ectropion, lymphedema, asymmetry, and dysfunction of the lids and lacrimal system. Conclusion. Adjacent-tissue skin grafts are a useful alternative for reconstruction of partial-thickness defects on the eyelid and periorbital area. ANDREW J. KAUFMAN, MD, HAS INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.