Dermatome (instrument)

A dermatome is a surgical instrument used to excise thin slices of skin from a donor site. These skin grafts are then used in reconstructive surgery, typically to cover areas damaged by burns, trauma, or surgical procedures.

Dermatomes come in various forms, broadly categorized as either hand-held or powered. Hand-held dermatomes, also known as knife dermatomes, require the surgeon to manually advance the blade. Powered dermatomes, on the other hand, utilize an electric or pneumatic motor to oscillate or rotate the cutting blade. The choice of dermatome depends on the size and shape of the area to be grafted, the thickness of the desired graft, and the surgeon's preference.

Key characteristics of dermatomes include the ability to precisely control the thickness and width of the skin graft. This precision is critical for successful graft take and optimal cosmetic outcomes. Common types of dermatomes include the Blair/Brown dermatome (a drum-type hand-held instrument), the Ferris Smith dermatome (a knife dermatome), and the Padgett dermatome (a powered instrument). The width of the skin graft can be adjusted using a calibrated plate or guard, while the depth (thickness) is controlled by adjusting the blade exposure or the angle of the instrument against the skin.

Following excision, the skin graft is typically meshed (small slits are cut into the graft) to allow for expansion and drainage of fluid, further improving the chances of successful graft survival. Dermatomes are essential tools in reconstructive surgery, allowing for the efficient and reliable harvesting of skin grafts for a variety of clinical applications.