Smashed skin grafting in stable vitiligo: Efficacy and safety

Background: Vitiligo is a common skin disorder that entails cosmetic disfigurement due to depigmentation and carries a social stigma. Smash grafting is an easy-to-master surgical treatment modality for stable vitiligo that has failed to respond to other treatments. The technique involves procuring a thin skin graft from a donor site, smashing it into the thinnest possible pieces, and grafting the smash onto the dermabraded vitiligo site. Objective: To analyze the efficacy and safety of smash grafting in patients with stable vitiligo. Materials and Methods: Thirty patients underwent smash grafting in stable recalcitrant vitiligo lesions. The patients were randomly placed in groups A and B. Group A received PUVASOL therapy postprocedure, while group B received only sunlight exposure after smash grafting. The patients were followed up every month for 3 months to assess repigmentation of the grafted site compared to the patient’s normal skin color. Results: Repigmentation was noticed at the grafted site starting as early as 3 weeks postprocedure in all the patients, and an increase in pigmentation intensity was observed until the end of the study follow-up. At the end of the 3-month follow-up, 76.66% of the patients had regained 50% or more pigmentation of the involved lesion. Conclusion: Smash grafting provided excellent repigmentation in >75% of patients without any significant complications. It is a simple and effective surgical technique that is underutilized. Furthermore, this procedure is less resource-intensive and easier to master than other surgical techniques for vitiligo.