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Preputial Grafts

The Forgotten Donor Site

Ehrlichman, Richard J., MD; Driscoll, Daniel N., MD; Cornejo, Kristine, MD; Upton, Joseph, MD

doi: 10.1097/SAP.0000000000001644
Hand Surgery

Background The prepuce is an excellent donor site for skin grafts with minimal donor site morbidity. Full-thickness grafts are often required for correction of congenital syndactyly and in burn contractures.

Methods Preputial skin was used for grafting in 18 children: 5 with burn contractures and 13 with congenital syndactyly.

Results Excellent graft take was achieved with appropriate postoperative care. Postoperatively, there were occasional milia (42%) and hyperpigmentation. These grafts were noted to have superior mobility and elasticity. There was no donor site morbidity.

Conclusions Preputial skin is accessible, easy to harvest, and hairless and has minimal donor site morbidity. It is especially well suited for the hands and fingers when elasticity of the graft is beneficial.

From the Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA.

Received March 9, 2018, and accepted for publication, after revision August 6, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Richard J. Ehrlichman, MD, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 15 Parkman St, WACC #435, Boston, MA 02112. E-mail:

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