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Historical Evolution of Skin Grafting—A Journey through Time
Review

A Narrative Review of the History of Skin Grafting in Burn Care

Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, TX 77550, USA
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Author to whom correspondence should be addressed.
Academic Editor: Lars P. Kamolz
Medicina 2021, 57(4), 380; https://doi.org/10.3390/medicina57040380
Received: 4 March 2021 / Revised: 28 March 2021 / Accepted: 7 April 2021 / Published: 15 April 2021
(This article belongs to the Special Issue A History of Burn Care)
Thermal injuries have been a phenomenon intertwined with the human condition since the dawn of our species. Autologous skin translocation, also known as skin grafting, has played an important role in burn wound management and has a rich history of its own. In fact, some of the oldest known medical texts describe ancient methods of skin translocation. In this article, we examine how skin grafting has evolved from its origins of necessity in the ancient world to the well-calibrated tool utilized in modern medicine. The popularity of skin grafting has ebbed and flowed multiple times throughout history, often suppressed for cultural, religious, pseudo-scientific, or anecdotal reasons. It was not until the 1800s, that skin grafting was widely accepted as a safe and effective treatment for wound management, and shortly thereafter for burn injuries. In the nineteenth and twentieth centuries skin grafting advanced considerably, accelerated by exponential medical progress and the occurrence of man-made disasters and global warfare. The introduction of surgical instruments specifically designed for skin grafting gave surgeons more control over the depth and consistency of harvested tissues, vastly improving outcomes. The invention of powered surgical instruments, such as the electric dermatome, reduced technical barriers for many surgeons, allowing the practice of skin grafting to be extended ubiquitously from a small group of technically gifted reconstructive surgeons to nearly all interested sub-specialists. The subsequent development of biologic and synthetic skin substitutes have been spurred onward by the clinical challenges unique to burn care: recurrent graft failure, microbial wound colonization, and limited donor site availability. These improvements have laid the framework for more advanced forms of tissue engineering including micrografts, cultured skin grafts, aerosolized skin cell application, and stem-cell impregnated dermal matrices. In this article, we will explore the convoluted journey that modern skin grafting has taken and potential future directions the procedure may yet go. View Full-Text
Keywords: skin graft; history; autograft; burn; dermatome; mesh; split-thickness; xenograft; CEA; CSS; Spray-on-Skin; ReCell skin graft; history; autograft; burn; dermatome; mesh; split-thickness; xenograft; CEA; CSS; Spray-on-Skin; ReCell
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MDPI and ACS Style

Ozhathil, D.K.; Tay, M.W.; Wolf, S.E.; Branski, L.K. A Narrative Review of the History of Skin Grafting in Burn Care. Medicina 2021, 57, 380. https://doi.org/10.3390/medicina57040380

AMA Style

Ozhathil DK, Tay MW, Wolf SE, Branski LK. A Narrative Review of the History of Skin Grafting in Burn Care. Medicina. 2021; 57(4):380. https://doi.org/10.3390/medicina57040380

Chicago/Turabian Style

Ozhathil, Deepak K., Michael W. Tay, Steven E. Wolf, and Ludwik K. Branski 2021. "A Narrative Review of the History of Skin Grafting in Burn Care" Medicina 57, no. 4: 380. https://doi.org/10.3390/medicina57040380

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