Self-Epithelization of Dermal Grafts

Abstract
THE USE of dermal grafts in head and neck surgery to protect the carotid artery from "blow outs" and to protect the esophageal suture line against fistulae was introduced by Corso and Gerald in 1963.1 These authors noted in their report that when there was skin breakdown over the graft it became epithelized and this epithelization appeared to come from the graft itself. One of us ( G. F. Reed) has made the same clinical observation.2 This apparent self-epithelization of dermal grafts, when exposed, becomes of great potential clinical significance. If true, one might use this grafting material to take advantage of its strength and viability in applications where it would be purposely exposed, if one could expect subsequent self-epithelization. Considerable work has been published documenting the fate of skin appendages in buried dermal implants. These studies indicate loss of hair follicles and sebaceous glands in approximately 2 to