As an alternative method to conventional split-thickness skin grafts (STSGs), we recently proposed fractional skin grafting (FSG), which consists in harvesting hundreds of microscopic skin tissue columns (MSTCs) to place them directly into the skin wound (Tam et al., 2013, “Fractional Skin Harvesting: Autologous Skin Graft Without Donor Site Morbidity,” Plast. Reconstructive Surgery–Global Open, 1(6)). This paper (i) introduces the concept and operational principles of a simple but robust fractional skin harvesting (FSH) device and (ii) presents the quantitative evaluation of the deployment of the FSH device with respect to different harvesting-needle sizes. The device utilizes a hypodermic needle with a specific cutting-geometry to core skin tissue mechanically. The tissue core is removed from the donor site into a collecting basket by air and fluid flows. The air flow transports the tissue core, while the fluid flow serves the purpose of lubrication for tissue transport and wetting for tissue preservation. The design and functionality of the device were validated in an animal study conducted to establish preclinical feasibility, safety and efficacy of the proposed FSH device and FSG method. The FSH device, operating at 55.16 kPa (8 psi) gauge pressure and 208 ml/min saline flow rate, cored 800 μm diameter × 2.5 mm length skin columns using a 1.05/0.81 mm outer/inner diameter needle. The MSTC harvesting rate was established by the user at 1 column/sec. For this columns size, about 50 MSTCs are required to cover a 1.5 cm × 1.5 cm wound. In comparison to STSGs, the proposed FSG method results in superior healing outcomes on the donor and wound sites. Most important, the donor site heals without morbidity by remodeling tissue, as opposed to scarring. The FSH device has the capability of extracting full-thickness skin columns while preserving its viability and eliminating the donor site morbidity associated with skin grafting.
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December 2014
Research-Article
Fractional Skin Harvesting: Device Operational Principles and Deployment Evaluation
Walfre Franco,
Walfre Franco
1
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
e-mail: wfranco@mgh.harvard.edu
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
e-mail: wfranco@mgh.harvard.edu
1Corresponding author.
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Joel N. Jimenez-Lozano,
Joel N. Jimenez-Lozano
2
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
2Present address: ZELTIQ Aesthetics Inc.
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Joshua Tam,
Joshua Tam
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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Martin Purschke,
Martin Purschke
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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Ying Wang,
Ying Wang
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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Fernanda H. Sakamoto,
Fernanda H. Sakamoto
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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William A. Farinelli,
William A. Farinelli
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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Apostolos G. Doukas,
Apostolos G. Doukas
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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R. Rox Anderson
R. Rox Anderson
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
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Walfre Franco
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
e-mail: wfranco@mgh.harvard.edu
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
e-mail: wfranco@mgh.harvard.edu
Joel N. Jimenez-Lozano
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
Joshua Tam
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
Martin Purschke
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
Ying Wang
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
Fernanda H. Sakamoto
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
William A. Farinelli
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
Apostolos G. Doukas
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
R. Rox Anderson
Wellman Center for Photomedicine,
Massachusetts General Hospital,
Department of Dermatology,
Massachusetts General Hospital,
Department of Dermatology,
Harvard Medical School
,Boston, MA 02114
1Corresponding author.
2Present address: ZELTIQ Aesthetics Inc.
Manuscript received September 30, 2013; final manuscript received March 13, 2014; published online xx xx, xxxx. Assoc. Editor: Rafael V. Davalos.
J. Med. Devices. Dec 2014, 8(4): 041005 (9 pages)
Published Online: August 19, 2014
Article history
Received:
September 30, 2013
Revision Received:
March 13, 2014
Citation
Franco, W., Jimenez-Lozano, J. N., Tam, J., Purschke, M., Wang, Y., Sakamoto, F. H., Farinelli, W. A., Doukas, A. G., and Rox Anderson, R. (August 19, 2014). "Fractional Skin Harvesting: Device Operational Principles and Deployment Evaluation." ASME. J. Med. Devices. December 2014; 8(4): 041005. https://doi.org/10.1115/1.4027427
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