Dermatome — Overview
A dermatome is a calibrated skin-harvesting instrument that produces uniform-thickness split-thickness skin grafts (STSG). The class spans powered and handheld devices — each with distinct trade-offs in precision, portability, and setup complexity.
Variants
- Zimmer Air DermatomePneumatic powered — US workhorse; requires compressed-gas supply.
- Padgett DermatomeElectric powered — alternative to Zimmer, wall-outlet power only.
- Humby DermatomeHandheld manual — classic British design; limited-resource workhorse.
- Goulian (Weck) DermatomeSmall handheld — narrow grafts, built-in depth guard.
- Drum Dermatome (Padgett-Hood)Historical rotating-drum design — the 1939 origin of calibrated STSG harvest.
- Skin MesherNot a dermatome proper — expands a harvested graft at a fixed ratio.
Key Uses in Reconstructive Urology
- Scrotal reconstruction after Fournier's gangrene — the single most common indication
- Resurfacing after radical skin excision for hidradenitis suppurativa, severe lichen sclerosus, or buried penis reconstruction
- Coverage over tissue expanders in staged penile reconstruction
- Meshed STSG for large wound coverage in genital / perineal reconstruction
- Phalloplasty donor-site coverage (radial forearm, ALT, musculocutaneous latissimus dorsi)
Typical Harvest Sites
- Anterolateral thigh — most common donor site for genital reconstruction
- Anterior thigh
- Back (buttock or scapular area) for cosmetically hidden donors
Typical Thickness
- 0.012"–0.018" for genital / perineal coverage
- 0.018"–0.025" for more robust recipient sites
See also: STSG, Grafts in GU Reconstruction, Fournier's Gangrene, Quilting Stitch.