Clinical Evaluation of a Novel Device for the Creation of Micrografts: A Pilot Case Series.

BACKGROUND: Skin grafting is a standard treatment for full-thickness wounds. Split-thickness grafts perform well in compromised wound beds but create open donor sites, whereas full-thickness grafts allow primary closure but may have reduced graft take in chronic wounds. Morselizing full-thickness grafts into micrografts may improve imbibition and drainage while preserving the advantages of full-thickness skin and allowing for a closed donor site. This pilot study evaluates a novel skin morselization device (TissueMil) for preparing full-thickness skin micrografts for grafting chronic wounds. METHODS: Ten patients with full-thickness wounds that had failed to improve after at least 4 weeks of standard care were treated with full-thickness skin micrografts processed using the TissueMil device. Elliptical grafts were harvested from the trunk or groin and closed primarily. Grafts were morselized into micrografts approximately 500-750 µm in size and applied to prepared wound beds. Patients were followed up to assess graft take, healing time, and donor site morbidity. RESULTS: All treated wounds demonstrated 95%-100% graft take. Complete healing occurred within 21-98 days (2.5-14 wk). All donor sites healed within 2 weeks without infection or dehiscence. Procedures were performed in the outpatient setting under local anesthesia with an average duration of approximately 30 minutes. CONCLUSIONS: Full-thickness skin micrografts prepared with a novel morselization device achieved high graft take and reliable healing while allowing primary donor site closure. Device-assisted preparation may simplify clinical use of full-thickness micrografting. Larger controlled studies are warranted.