Comparison of outcomes for single-session and delayed full-thickness applications of meshed skin grafts used to close skin defects after excision of tumors on the distal aspects of the limbs in dogs

A Comparative Review of Meshed Versus Unmeshed Grafts in Split-Thickness Skin Grafting: Clinical Implications and Outcomes

Split-thickness skin grafting (STSG) is a cornerstone technique in reconstructive surgery, offering solutions for covering wounds, burns, and other skin defects. This review compares meshed versus unmeshed STSG, focusing on their clinical implications and outcomes. Meshed grafts, created by perforating the skin graft to form a mesh-like pattern, are frequently used for larger or irregularly shaped areas due to their ability to expand and conform to the underlying tissue. In contrast, unmeshed grafts are applied as whole sheets, making them suitable for smaller or cosmetically sensitive regions where appearance is paramount. This review examines various aspects of these graft types, including graft survival rates, aesthetic and functional results, healing times, and complications such as infection and graft contraction. This study aims to identify the relative advantages and drawbacks of meshed versus unmeshed grafts by analyzing data from clinical trials, meta-analyses, and systematic reviews. The findings highlight that while meshed grafts offer improved coverage and reduced risk of graft failure, unmeshed grafts are preferred for their superior cosmetic outcomes. Understanding these differences is crucial for optimizing surgical strategies and improving patient outcomes. The review also addresses patient-specific factors and recommends selecting the appropriate graft type based on clinical scenarios.

Nigeria bee honey-enhanced adherence, neovascularisation and epithelisation of full-thickness skin autografts on distal extremities of dogs

BACKGROUND

Full thickness skin grafts (FTSGs), although ideal for resurfacing large defects of the distal extremities in veterinary patients, have a high failure rate due to issues of adherence, infection and inadequate revascularisation because of its thickness and high nutritional demand. This study investigated the effect of Nigeria bee honey on FTSG take at the distal extremities of dogs. The study was conducted on 6 adult male Nigerian indigenous dogs using 3 of the 4 limbs of each dog randomly divided into 3 treatment groups: Nigerian bee honey (HON group), platelet-rich plasma (PRP group) and normal saline (CON group). Full-thickness skin wounds (3 cm × 1.5 cm) were created on the lateral aspect of the radioulnar or metatarsal areas and dressed till adequate granulation tissues formed. Donor skins harvested from the lateral thorax of each dog were sutured to the recipient bed following application of the assigned treatment, and evaluated grossly and histologically on days 0, 4, 7, 10, 14, 17, and 21.

RESULTS

A higher percentage (4/6 representing 66.7%) of complete graft take was observed in the HON and PRP groups as compared to 3/6 (50%) in the CON group. The HON group had a greater percentage (5/6 representing 83.3%) of adhered grafts as compared to the PRP (4/6 representing 66.7%) and CON (3/6 representing 50%) groups at day 4. There was a significant decrease (p = 0.022) in percentage necrosis between the CON and HON/PRP groups on day 10, 14 and 17. The percentage open mesh area for the HON group was significantly lesser at day 4, 7 and 10 when compared with CON (p < 0.001) and at day 4 when compared with PRP (p = 0.001). At histology, graft neovascularisation score was highest in the HON group on days 4, 14 and 21.

CONCLUSION

Nigeria bee honey enhanced take of meshed full-thickness skin autografts by promoting adherence to the recipient bed, enhancing fibroblast proliferation and collagen laydown, and accelerating the rate of neovascularisation suggesting promising application as an alternative modality to enhance FTSG take.