Pinch and punch grafts: When and how?

Summary Wound healing, particularly of the distal limbs in horses, is well known to be unsatisfactory and problematic with the formation of exuberant granulation tissue. Grafting large wounds greatly reduces the healing and convalescence time as well as improving the functional and cosmetic appearance of the healed wound. Grafting should be considered for full-thickness skin wounds that cannot heal by contraction and epithelialisation or be closed by suturing or the use of sliding flaps. The healed skin graft consists of epidermis, dermis and some adnexa, including hair follicles, which means that the new skin will be much more resilient and elastic compared with scar tissue or the dense fibrogranulomas that can result following the formation of excessive granulation tissue. Skin grafting should not be feared or considered as a last resort but should form part of a well-formulated plan when the wound is first examined ...