Microskin Grafting by Spraying Method in Extensive Vitiligo Management

Abstract

Donor to recipient area ratio can be increased upto 1:15 by spraying method. For rapid and uniform pigmentation in 3–5 months time, the donor to recipient ratio should not be expanded beyond 1:8. Expansion beyond 1:15 will take longer time to repigment the area and some times residual lesions may need secondary surgery for repigmentation. During secondary surgery, the small residual intervening vitiliginous areas can be dermabraded carefully by diamond fraise to avoid abrasion of pigmented area. This is followed by the application of MSGs, which are floated in normal saline, with the help of sterilized dropper. The number of MSGs depends on the area of vitiliginous patch. For example an area of 0.25 cm² (0.5×0.5 cm) will ideally require only one MSG. Practically, I used to put at least 2–3 MSGs in such a small area due to uncertainty of orientation of graft.