Multiple mini punch grafts for extensive ulcer: a case report

Abstract

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