Hypergranulation-induced graft failure in meshed split thickness skin graft: A case report

Objective

Meshed split-thickness skin grafts (mSTSG) are frequently used to address skin defects. Effective fixation methods are crucial for optimizing graft integration and minimizing complications. This case report demonstrates the role of negative pressure wound therapy (NPWT) in managing recurrent axillary hidradenitis suppurativa.

Methods

A 65-year-old male with recurrent axillary hidradenitis suppurativa underwent mSTSG placement, followed by NPWT to support graft integration. The initial graft failed due to necrotic hypergranulation, necessitating regrafting and personalized postoperative care.

Results

Initial graft failure occurred due to necrotic hypergranulation at the graft site. After regrafting, NPWT facilitated granulation tissue formation and enhanced healing. Complications such as hypergranulation required continuous monitoring and intervention. The patient ultimately showed significant clinical improvement with successful graft integration.

Conclusion

NPWT can enhance graft survival and wound healing in complex cases of recurrent axillary hidradenitis suppurativa. However, vigilant monitoring is essential to manage complications such as necrotic hypergranulation. Personalized postoperative care and timely interventions are key to overcoming graft failures and achieving optimal outcomes. Tailoring treatment strategies to individual wound healing dynamics is crucial for long-term success.