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Waste Not, Want Not: Technique to Use Redundant Skin from Elliptical Skin Lesion Excision

Bhat, Waseem M.R.C.S.; Akhtar, Sohail M.R.C.S.; Akali, Augustine F.R.C.S.(Plast.)

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Plastic and Reconstructive Surgery: September 2010 - Volume 126 - Issue 3 - p 140e-141e
doi: 10.1097/PRS.0b013e3181e3b5d3
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Sir:

Patients often present with multiple skin lesions requiring excision. In some instances, one or more of the lesions once excised will require a skin graft to close the resulting defect. In some but not all such cases, we suggest a technique to optimize the use of redundant skin excised during surgery in such a way as not to require a separate incision from which to harvest a skin graft. We suggest using the redundant but healthy skin from the elliptical skin portions removed following excision of a benign lesion as a skin graft to cover the defect from a second lesion, excised from the same patient.

In a case used to illustrate our technique, the patient had two lesions requiring excision: a benign lesion on the left temple and a second lesion on the left alar region. An elliptical excision was performed to remove the lesion from the left temple (Fig. 1). The lesion around the left alar region was excised as marked. The skin from the excision ellipse of the lesion from the temple was then used as a full-thickness skin graft to cover the resultant defect to the left ala. The left temple wound was closed directly. Should the size of skin from the ellipse be judged to be too small for the defect, a slightly longer ellipse can be performed in some instances to obtain enough skin to reconstruct the defect. This method obviates the need for making a further incision to harvest skin, therefore reducing scarring and operative time.

Fig. 1.
Fig. 1.:
Patient with a benign lesion on the left temple and a second lesion on the left alar region.

One method of optimizing the use of redundant skin has been described.1 We suggest that the technique described is another method of using skin that would otherwise be discarded; however, only skin remaining following excision of a benign lesion (and not malignant) should be used. Our technique also removes the need for an additional donor-site scar.

Waseem Bhat, M.R.C.S.

Sohail Akhtar, M.R.C.S.

Augustine Akali, F.R.C.S.(Plast.)

Department of Plastic Surgery

Castle Hill Hospital

Hull, United Kingdom

PATIENT CONSENT

The patient provided written consent for the use of his image.

REFERENCE

1.Nambi GI, Gupta KA. An insurance policy for wound healing in abdominoplasty patients. J Plast Reconstr Aesthet Surg. 2009;62:558.

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