Multiple mini punch grafts for extensive ulcer: a case report
Multiple mini punch grafts is the placing of mini size of full thickness skins on to ulcer bed. They consist of epidermal and dermal component composed with hair follicles and other skin appendices where epidermal stem cells are located. The epidermal stem cells are the best source of epidermal cells in reconstruction of skin equivalent that is usually used for replacing classic split thickness skin graft in recovering extensive ulcer. In this article, the application of multiple mini punch grafts onto extensive ulcer is reported. A case of extensive ulcer was suffered by a 6-year-old boy whose left foot is injured in a traffic accident. His toes had already been amputated by surgeon but a classic skin graft failed to recover the ulcer. Multiple mini punch grafts had been harvested from his inguinal and buttock skin and they were placed onto his ulcer. Pre and post mini punch grafting photographs were reviewed. After eight weeks, placed multiple mini punch tissues onto large ulcer reveals lateral extensions and more than 90% of epithelialization. Multiple mini punch grafts can be used as a method to cover large ulcer. Key words: mini punch grafts-large ulcer-epithelialization-epidermal-stem cells