Harvesting of preauricular full-thickness skin graft
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This is Richard Allen at the University of Iowa.
This video demonstrates the harvesting of a preauricular full-thickness skin graft.
A template has been made of the defect and a marking pen is used to make an outline around the template. This is in the non-hair bearing skin of the preauricular area, just in front of the tragus. A 15 blade is then used to make an incision along the marking through the skin and underlying subcutaneous fat. Westcott scissors are used to excise the graft. I think you are completely safe in the plane of the subcutaneous fat, which is far anterior to the branches of the facial nerve. The area can be widely undermined, if needed, and then closed with deep interrupted 5 or 4-0 Vicryl sutures. The skin can then be closed with interrupted 5-0 Prolene sutures. The advantage of this area is the ease of harvest and the area heals well with an unnoticeable scar. Antibiotic ointment is placed over the incision and the patient returns in one week for suture removal.
