Ten years later – scalp still a primary donor site in children

Choice of the donor site for a split thickness skin graft depends on skin availability, possible complications and anticipated esthetic results. We selected the scalp to be the primary donor site at our institution. During a period of ten years (1998–2008), a group of 123 pediatric patients aged 4 months to 15 years (65% were below the age of 2; mean age 2.98 years) underwent skin grafting from this particular site. In 2 cases the same area was re-harvested. All donor sites healed by the 10th post-operative day. Donor site complications included: 2 microalopecia regions, 5 pressure sores in a close proximity, 1 hypertrophic scar and 1 visible mark on the forehead due to technical mistake in graft harvesting. All children started scar management of the recipient site with contact therapy using adhesive tape Hypafix (BSN Medical); subsequently moving on to silicone sheets or gel in selected refractory cases. We present results for 68 scars in 41 patients with the longest follow-up period. Scar quality was evaluated after minimum of 10 years and scored according to the Vancouver Scar Assessment Scale. Very good and good results were obtained in 55 scars (80.9%), satisfactory in 11 scars (16.2%) and unsatisfactory in 2 scars (2.9%). Conclusions Our results confirm, that the scalp is a reliable donor site in children and contact therapy is an adequate form of scar prevention/treatment of the recipient site.