Pinch Grafting Versus Second Intention Wound Healing for Mohs Micrographic Surgery Defects on the Scalp

Last updated: April 17, 2025
Sponsor: University of California, Davis
Overall Status: Active - Recruiting

Phase

N/A

Condition

Scar Tissue

Treatment

Pinch Graft

Clinical Study ID

NCT06287866
2099470
  • Ages > 18
  • All Genders

Study Summary

Oftentimes, following surgery on the scalp, wounds are left to heal by themselves. This is called "second intention." Open wounds left to heal on the scalp often take 8 weeks or more to completely heal. The investigators are investigating how second intention closure compares to another established reconstruction technique, called "pinch graft." In the pinch graft technique, a dermatological surgeon numbs and then shaves off a thin piece of skin (usually from the groin area) and places it in the wound bed it (also known as "grafting"), to encourage growth of new healthy skin. This study will compare time-to-healing in the second intention method versus the pinch graft method.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • 18 years of age or older

  • Able to give informed consent themselves

  • Patient scheduled for cutaneous surgical procedure on the scalp with predictedsecond intention closure

  • Willing to return for follow up visit

  • Active user of MyChart

  • Willing to send weekly messages until wound is healed

Exclusion

Exclusion Criteria:

  • Incarceration

  • Under 18 years of age

  • Pregnant women

  • Unable to understand written and oral English

  • Scalp wounds with planned primary repair reconstruction

  • Surgical defects with bone exposure

  • No MyChart access or use

Study Design

Total Participants: 50
Treatment Group(s): 1
Primary Treatment: Pinch Graft
Phase:
Study Start date:
April 02, 2024
Estimated Completion Date:
October 01, 2025

Study Description

Pinch graft methodology was first developed in 1976 as a treatment to accelerate healing of lower leg ulcerations, particularly venous or gravitational ulcerations (1, 2). It was later adapted as a tool to hasten healing in surgical wounds, such as surgical closure of diabetic foot wounds (3). It has also been used in the healing of patients with wounds related to dystrophic epidermolysis bullosa (4). More recently, pinch grafts have been investigated as a reconstruction option for Mohs micrographic surgery defects (5). In this study, patients with below the knee Mohs surgical defects were randomized to receive either PG reconstruction or SIH reconstruction. Patients with PG reconstruction healed 20 days sooner (i.e., faster time to reepithelialization) than those who underwent SIH. Complication rates, including infection and reported pain, were also lower in the PG cohort compared to the SIH cohort. SIH is often recommended as a reconstruction technique for surgical wounds without adjacent skin laxity to support primary closure, such as the anterior lower extremity and scalp. There is no study to date examining the use of pinch grafts in scalp wounds. In our study, the investigators explore whether PG is a viable and useful reconstruction method for wounds on the scalp that otherwise would be left to close via SIH. Specifically, in our study, the investigators examine the comparative time to healing and complication rates between PG and SIH in Mohs surgical defects of the scalp.

Connect with a study center

  • University of California, Davis - Dermatology Department

    Sacramento, California 95816
    United States

    Active - Recruiting

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