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Surg Radiol Anat (2002) 24: 183189 DOI 10.

1007/s00276-002-0034-5

O R I GI N A L A R T IC L E

Y. Lee K. Hwang

Skin thickness of Korean adults

Received: 30 August 2001 / Accepted: 26 January 2002 / Published online: 12 July 2002 Springer-Verlag 2002

Abstract Skin thickness varies considerably between dierent races and age-groups, between men and women, and between dierent regions of the body surface. A few authors reported the skin thickness of dierent regions of the body, but no detailed study have been performed on Asian. We performed 452 biopsies on 28 dierent regions of the normal skin of Korean men and women. The specimens were stained with hematoxylineosin and measured microscopically. The thickness of the skin (epidermis plus dermis) ranged from 521 to 1,977 lm; the eyelid, prepuce, and inguinal skin was thinnest (521626 lm), and the back was thickest (1,977 lm). The thickness of the epidermis varied from 31 to 637 lm; skin thickness in the prepuce, eyelid, supraclavicular region, postauricular region, and axilla ranged from 31 to 71 lm; the buttock, dorsum of the hand, and dorsum of the foot were relatively thick (138 189 lm); the palm and sole were thickest (601637 lm).

The thickness dermis varied from 469 to 1,942lm; skin thickness in the eyelid, prepuce, inguinal region, and postauricular region ranged from 469 to 645 lm; the buttock, chest, and anterior neck were relatively thick (13181586 lm); the back was thickest (1,942 lm). The epidermis accounted for 3.716.8% of the entire skin in most regions, except in the palm and sole (40.644.6%). Thickness data may be useful in harvesting full- or splitthickness skin grafts. The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00276-0020034-5. paisseur de la peau des Core ens adultes Le sume Le paisseur de la peau varie conside rablement Re gion du en fonction de la race, de la ge, du sexe et de la re re e. Peu dauteurs ont rapporte le paisseur corps conside rentes re gions du corps, mais nous de la peau des die aucune e tude de taille e de la peau des navons trouve alise 452 biopsies de 28 re Asiatiques. Nous avons re rentes de la peau normale de Core ens et de gions die ennes. Les e chantillons e taient colore s a ` lhe matCore osine et mesure s au microscope. Le paisseur de oxyline-e piderme et le derme) variait de la peau (comprenant le ` 1277 l ; la paupie ` re, le pre puce, la peau inguinale 521 a taient les plus ns (521 a ` 626 l) ; la peau du dos e tait la e paisse (1977 l). Le paisseur de le piderme variait plus e ` 637 l ; le pre puce, la paupie ` re, les re gions suprade 31 a tro-auriculaire, et laisselle e taient les claviculaire et re ` 71 l) ; les fesses, le dos de la main et du plus nes (31 a taient relativement e pais (138 a ` 189 l) ; le piderme pied e tait le de la paume de la main et de la plante du pied e pais (601 a ` 637 l). Le paisseur du derme variait de plus e ` 1942 l ; elle e tait de 469 a ` 645 l au niveau de la 469 a ` re, du pre puce, des re gions inguinale et re tropaupie tait relativement e pais (1318 a ` 1586 l) au auriculaire. Il e rieure niveau des fesses, de la poitrine et de la partie ante tait le plus e pais au niveau du dos (1942 l). du cou, il e piderme par rapport a ` la peau totale La proportion de

The French version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at http://dx.doi.org/10.1007/s00276002-0034-5. Y. Lee Department of Plastic Surgery, College of Medicine, Seoul National University, 28 Yeongun-dong, Chongno-gu, Seoul, 100-744, Korea K. Hwang (&) Department of Plastic Surgery, College of Medicine, Inha University, 7-206 Shinheung-dong, Choong-gu, Inchon, 400-711, Korea E-mail: jokerhg@inha.ac.kr Tel.: +82-32-8903514 Fax: +82-32-8902918 Correspondence to: Kun Hwang Department of Plastic Surgery, Inha University Hospital, 7-206 Shinheung-dong, Choong-gu, Inchon, 400-711, Korea

184

gions, variait entre 3,7 et 16,8% dans la plupart des re sauf au niveau de la paume de la main et de la plante du ` 44,6%). Les donne es concernant le paisseur pied (40,6 a le ` vement des de la peau peuvent e tre utiles pour le pre grees de peau mince ou de peau totale. Keywords Body regions Skin Epidermis Dermis

Materials and methods


We performed 452 biopsies in 28 dierent regions of the normal skin of Korean men and women (Fig. 1). The skin samples were taken from 452 living subjects (248 men, 204 women; age range, 1650 years) who underwent skin operations (e.g., skin aps, tumor surgery, cosmetic surgery, etc.). One biopsy was performed on each subject. Before removing the skin, a benzoic tincture and dermatape were applied to the skin area to be harvested to prevent shrinkage. Just after they had been harvested, the skin samples were put on a wooden board and the four corners of the skin were xed with pins. The skin xed on the board was stored in 10% formaldehyde solution. The formalin-xed skin samples were processed using routine histologic procedures and embedded in paran. Sevenmicrometer sections were cut using a microtome. The specimens were stained with hematoxylin-eosin (H&E). Skin thickness was measured under a microscope at micrometer strength. The epidermis was measured ve times from the free margin of skin to the dermal papillae and epidermal ridge. The dermis was measured in the same way from the epidermal ridge and dermal papillae to the dermalfat junction (Fig. 2). The mean values and standard deviations were calculated, and the sex difference was compared using Students t-test (SPSS version 7.0).

Introduction
Skin thickness varies considerably according to the race, age, sex, and region of the body surface. A few authors [1, 2, 3] reported the skin thickness of dierent regions of the body, but no detailed study has been performed on Asian skin. We measured the thickness of skin from 28 dierent regions of Korean men and women.

Results
Skin thickness (epidermis plus dermis) ranged from 521 to 1,977 lm; the eyelid, prepuce, and inguinal skin was thinnest (521626 lm), and the back was thickest (1,977 lm) (Table 1). The thickness of the epidermis varied from 31 to 637 lm; thickness in the prepuce, eyelid, supraclavicular region, postauricular region, and axilla ranged from 31 to 71 lm; the buttock, dorsum of the hand, and dorsum

Fig. 1. Regions of the human body from which skin specimens were obtained for this study. 1, Forehead; 2, eyelid; 3, cheek; 4, chin; 5, postauricular region; 6, neck (anterior.); 7, supraclavicular region; 8, axilla; 9, chest; 10, abdomen; 11, back; 12, inguinal region; 13, buttock; 14, penis; 15, front of arm; 16, back of arm; 17, front of forearm; 18, back of forearm; 19, dorsum of hand; 20, palm; 21, front of thigh; 22, lateral thigh; 23, back of thigh; 24, anterior leg; 25, lateral leg; 26, back of leg; 27, dorsum of foot; 28, sole

Fig. 2. Measuring the thickness of skin. Thickness of epidermis = (a+b)/2, thickness of dermis = (c+d)/2

185 Table 1. Thickness of skin of body regions Region Forehead Eyelid Cheek Chin Postauricular r. Neck (anterior) Supraclavicular r. Axilla Chest Abdomen Back Inguinal r. Buttock Penis Front of arm Back of arm Front of forearm Back of forearm Dorsum of hand Palm Front of thigh Lateral thigh Back of thigh Anterior leg Lateral leg Back of leg Dorsum of foot Sole Specimens (n) 14 28 28 15 18 14 6 12 18 29 23 19 14 11 11 14 17 8 12 11 17 18 14 20 22 15 13 11 Epidermis (lm) 93.622.3 54.49.6 98.226.7 84.023.3 67.915.1 91.121.8 62.916.1 70.624.7 98.537.2 79.433.9 76.825.9 77.833.5 137.754.5 31.25.7 69.221.9 83.536.2 74.125.4 102.134.0 189.263.1 600.996.8 87.427.7 94.823.6 102.348.6 91.225.8 109.218.3 129.644.1 163.118.6 637.1186.0 Dermis (lm) 788.2145.6 469.2119.7 1,076.6225.0 763.9317.1 645.1215.3 1,318.2364.2 706.8211.7 940.3176.2 1,337.9332.3 1,248.4262.5 1,941.6321.1 548.0266.2 1,585.5536.3 514.8145.0 943.4235.6 1,030.4327.8 1,020.4208.5 1,077.4161.5 932.9121.9 745.6163.5 1,058.1147.6 1,217.6318.3 1,006.5219.7 921.5194.3 1,013.4307.2 981.6148.2 1,001.1259.2 931.9411.2 E+D (lm) 865.9136.8 521.2115.8 1,141.1292.3 857.1247.8 712.9213.1 1,408.0362.1 770.0220.5 1,011.1178.1 1,438.5319.7 1,331.6254.2 1,976.9395.1 625.9273.4 1,721.4555.1 546.0141.9 1,012.6233.3 1,171.8379.3 1,133.1214.7 1,182.0165.0 1,065.0130.4 1,349.4189.5 1,144.0156.2 1,331.9333.5 1,118.5178.1 1,016.0219.8 1,122.8208.4 1,052.4261.3 1,164.4280.9 1,569.0582.7 E/(E+D) (%) 10.6 7.5 8.3 9.9 9.5 6.4 8.1 6.9 6.8 6.0 3.7 12.4 7.9 5.7 6.8 7.4 6.7 8.7 16.8 44.6 8.2 7.2 9.2 9.0 9.7 11.6 14.0 40.6

Table 2. Skin specimens by sex and region Region Forehead Eyelid Cheek Chin Postauricular r. Neck (anterior) Supraclavicular r. Axilla Chest Abdomen Back Inguinal r. Buttock Penis Front of arm Back of arm Front of forearm Back of forearm Dorsum of hand Palm Front of thigh Lateral thigh Back of thigh Anterior leg Lateral leg Back of leg Dorsum of foot Sole Total Male (n) 8 11 14 6 8 8 3 6 10 15 13 9 7 11 6 6 11 4 8 5 10 10 6 12 12 9 9 6 243 Female (n) 6 17 14 9 10 6 3 6 8 14 10 10 7 _ 5 8 6 4 4 6 7 8 8 8 10 6 4 5 209 Total (n) 14 28 28 15 18 14 6 12 18 29 23 19 14 11 11 14 17 8 12 11 17 18 14 20 22 15 13 11 452

of the foot were relatively thick (138189 lm); the palm and sole were thickest (601637 lm) (Table 1). The thickness of the dermis varied from 469 to 1,942 lm; thickness in the eyelid, prepuce, inguinal region, and postauricular region ranged from 469 to 645 lm; the buttock, chest, and anterior neck were relatively thick (13181586 lm); the back was thickest (1,942 lm) (Table 1). The epidermis accounted for 3.716.8% of the entire skin in most regions, except in the palm and sole (40.6 44.6%) (Table 1). Skin thickness diered signicantly in men and women (Table 2). The skin of the cheek, back, anterior aspect of the upper extremity, dorsum of the hand, back of the thigh, and sole was thicker in men than in women (Table 3, 4). The epidermis of the extensor surface of the forearm was thicker than the exor side. The remaining regions showed less dierence in epidermal thickness (Table 5). The skin of the proximal and intermediate sides of the leg was thicker than that of the distal side (Table 6). Table 7 shows a comparison of skin thickness in Caucasians and Koreans. It is noteworthy that epidermal thickness and the proportion of the skin accounted for by the epidermis are higher in Koreans than in Caucasians.

Discussion
In measuring skin thickness, the shrinkage eect is the most important problem to be prevented. Before

186

Table 3. Rank order of thickness of skin according to sex Dermis (lm) Female Palm 647.4 Sole 478.1 Dorsum of foot 175.3 Dorsum of hand 132.2 Buttock Posterior leg Lateral leg Chest Lateral forearm Lateral thigh Neck (anterior) Forehead Medial thigh Posterior thigh Cheek Chin Medial forearm Abdomen Medial leg Lateral arm Inguinal r. 72.1 Medial arm 65.5 Postauricular r. 63.5 Supraclavicular r. 63.1 Back 59.6 Axilla 54.6 Eyelid 49.9 Penis n/a Medial leg Forehead Chin Palm Postauricular r. Eyelid Penis Inguinal r. 72.5 Supraclavicular r. 888.4 887.2 822.5 813.9 718.0 697.7 516.3 514.8 429.3 79.9 78.3 Dorsum of hand 1,003.4 Axilla 891.9 80.3 Medial thigh 1,012.1 85.0 81.5 Medial arm Posterior leg 1,094.3 1,073.2 91.9 90.4 89.3 88.1 Lateral leg Posterior thigh Medial forearm Lateral forearm 1,127.8 1,126.7 1,104.2 1,099.4 Posterior leg Lateral arm Cheek Lateral leg 931.3 925.8 909.4 898.9 896.2 888.3 862.3 794.4 790.5 785.4 Forehead 753.8 Chin 663.7 Sole 610.3 Postauricular r. 575.2 Supraclavicular r. 525.3 Inguinal r. 423.5 Eyelid 400.5 Penis n/a 97.1 92.6 Dorsum of foot 1,228.8 Cheek 1,197.3 Medial thigh Posterior thigh 986.9 934.0 111.1 101.0 Lateral arm Lateral thigh 1,252.0 1,239.0 Lateral thigh Axilla 1,026.4 988.6 Chest Lateral thigh 127.5 116.2 Chest Sole 1,297.9 1,253.4 1,146.6 1,097.4 1,363.4 1,162.5 1,561.1 1,437.9 1,409.0 1,390.3 1,349.7 1,271.4 1,254.2 1,239.8 1,237.4 1,219.1 1,212.1 1,197.6 1,192.6 1,171.9 1,162.7 1,000.4 Medial leg Axilla Supraclavicular r. Forehead Chin Postauricular r. Eyelid Penis Inguinal r. 987.8 981.6 958.6 900.9 891.3 766.7 569.4 546.0 503.1 2,180.1 1,531.1 1,471.8 Back Buttock Chest 1,783.0 1,639.9 1,337.8 Back Sole Buttock 2,277.9 2,049 1,678.9 Male Female Male Female Buttock Chest Back Palm 1,728.4 1,486.2 1,470.7 1,427.4 1,351.3 1,255.4 1,225.3 1,194.5 1,128.6 1,088.1 Medial thigh Dorsum of foot Posterior leg Cheek Axilla Posterior thigh Lateral leg Dorsum of hand Medial leg 1,077.1 1,051.4 1,047.5 1,044.4 1,040.5 1,023.3 1,007.7 993.7 974.6 E+D (lm)

No.

Epidermis (lm)

Male

1 2 3

Sole 792.8 Palm 557.3 Dorsum of hand 246.8

Dorsum of foot 180.1

Back Buttock Neck (anterior) Abdomen Neck (anterior) Abdomen Lat. forearm Neck (anterior) Abdomen Dorsum of foot

5 6

Buttock Posterior leg

147.8 124.4

7 8

115.4 112.7

9 10

Cheek Lateral forearm Lateral thigh Lateral leg

110.7 109.5

Lateral arm Neck (anterior) Abdomen Lateral forearm Lateral thigh Sole

11 12 13 14

Medial thigh Lateral arm Medial leg Forehead

103.7 101.2 100.6 95.9

15 16

Posterior thigh Neck (anterior)

92.4 89.3

Palm Dorsum of hand Lateral leg Cheek Posterior thigh Lateral forearm Posterior leg Medial arm

17

Chest

88.1

18 19

Back Axilla

88.1 85.8

Medial forearm Medial thigh Lateral. arm

20

Chin

84.4

Medial leg Dorsum of foot Dorsum of hand Medial arm Medial forearm Palm

21 22 23 24 25 26 27 28

Abdomen Supraclavicular r. Inguinal r. Medial arm Postauricular r. Medial forearm Eyelid Penis

80.4 76.3 73.7 72.8 69.3 67.8 57.7 31.2

Medial 871.4 forearm Forehead 835.7 Medial arm 828.7 Chin 746.8 Postauricular r. 657.1 Supraclavicular r. 558.8 Inguinal r. 495.6 Eyelid 473.0 Penis n/a

n/a, not applicable

187 Table 4. Sexual dierences of thickness of epidermis, dermis and skin Region Epidermis (lm) Male Forehead Eyelid Cheek Chin Postauricular r. Neck (anterior) Supraclavicular r. Axilla Chest Abdomen Back Inguinal r. Buttock Penis Front of arm Back of arm Front of forearm Back of forearm Dorsum of hand Palm Front of thigh Lateral thigh Back of thigh Anterior leg Lateral leg Back of leg Dorsum of foot Sole 95.9 57.7 115.4 84.4 69.3 89.3 76.3 85.8 88.1 80.4 88.1 73.7 147.8 31.2 72.8 101.2 67.8 112.7 246.8 557.3 1403.7 110.7 92.4 100.6 109.5 124.4 180.1 792.8 Female 90.4 49.9* 85.0** 81.5 64.5 91.9 63.1 54.6** 101.0 79.9 59.6* 72.1 127.5 n/a 65.5 72.5 80.3 97.1 132.2* 647.4 89.3 92.6 88.1 78.3** 111.1 116.2 175.3 478.1** Dermis (lm) Male 822.5 516.3 1,197.3 813.9 697.7 1,471.8 888.4 891.9 1,297.9 1,363.4 2,180.1 429.3 1,531.1 514.8 1,094.3 1,252.0 1,104.2 1,099.4 1,003.4 718.0 1,012.1 1,239.0 1,126.7 887.2 1,127.8 1,073.2 1,228.8 1,253.4 Female 735.8 400.5** 909.4** 663.7 575.2 1,162.5 525.3 988.6 1,377.8 1,146.6 1,783.0** 423.5 1,639.9 n/a 794.4** 925.8* 790.5** 1,097.4 862.3* 785.4 986.9 1,026.4 934.0 896.2 898.9 931.3 888.3* 610.3** E+D (lm) Male 900.9 569.4 1,237.4 891.4 766.7 1,561.1 958.6 981.6 1,390.3 1,437.9 2,277.9 503.1 1,678.9 546.0 1,192.6 1,000.4 1,171.9 1,212.1 1,254.2 1,271.4 1,162.7 1,349.7 1,219.1 987.8 1,239.8 1,197.6 1,409.0 2,049.4 Female 835.7 473.0* 1,044.4** 746.8 657.1 1,255.4 558.8* 1,040.5 1,486.2 1,225.3* 1,470.7** 495.6 1,728.4 n/a 828.7** 1,351.3 871.4** 1,194.5 993.7** 1,427.4 1,077.1 1,128.6* 1,023.3** 974.6 1,007.7 1,047.5 1,051.4* 1,088.1**

n/a, not applicable * P<0.05 (signicant dierence between values for men and women) ** P<0.01 (signicant dierence between values for men and women)

Table 5. Comparison of thickness of skin between functionally antagonistic regions Region A Medial arm (exor) (n=11) Medial forearm (exor) (n=17) Medial thigh (exor) (n=17) Posterior leg (exor) (n=15)
*

Epidermis (lm) B Lateral arm (extensor) (n=14) Lateral forearm (extensor) (n=8) Posterior thigh (extensor) (n=14) Lateral leg (extensor) (n=22) A 69.221.9 B 83.536.2
*

Dermis (lm) A B 943.4235.61,030.4327.8 1,020.4208.51,077.4161.5 1,058.1147.61,006.5219.7 981.6148.21,013.4307.2

E+D (lm) A B

1,012.6233.3 1,171.8379.3 1,133.1214.7 1,182.0165.0 1,144.0156.2 1,118.5178.1 1,052.4261.3 1,122.8308.4

74.125.4 102.134.0

87.427.7 102.348.6 129.644.1 109.218.3

P<0.05

harvesting skin from a living subject, we attached dermatape (to prevent shrinkage) with a benzoic tincture (to act as glue). As soon as we had harvested the skin, we xed it to a wooden board by putting pins into the four corners. The skin was submerged in formalin solution. We believe that this procedure prevented most of the shrinkage eect on the transverse plane, but that vertical shrinkage could not be entirely prevented. However, the rate of vertical shrinkage in each specimen seems to be similar, so we can say that we measured the comparative thickness of the skin in each body region.

Skin thickness varies between the dierent regions of the body surface. The skin on the back was thickest (1,977 lm). The palm (1,349 lm) and sole (1,569 lm) were also thick, but were composed mostly of epidermis. The thick dermis of the back (1,943 lm) and buttock (1,586lm) enables surgeons to repeatedly harvest splitthickness skin from these areas. In patients who have suered massive burns in whom the donor areas for skin grafts are limited, the back and buttock can act as reusable donor sites for split-thickness skin grafts. In contrast, the palm and sole have a thick epidermis and a relatively thin dermis (746 and 932 lm, respectively),

188 Table 6. Comparison of thickness of skin between proximal and distal parts of the same extremity Region A Medial arm (proximal) (n=11) Lateral arm (proximal) (n=14) Medial thigh (proximal) (n=17) Posterior thigh (proximal) (n=14) Lateral thigh (proximal) (n=18)
*

Epidermis(lm) B A B

Dermis (lm) A 943.4235.6 1,030.4327.8 1,058.1147.6 1,006.5219.7 1,217.6318.3 B 1,020.4208.5 1,077.4161.5

E+D (lm) A 1,012.6233.3 1,171.8379.3 B 1,133.1214.7 1,182.0165.0 1,016.0219.8* 1,052.4261.3 1,122.8208.4*

Medial forearm 69.221.9 74.125.4 (distal) (n=17) Lateral forearm 83.536.2 102.134.0 (distal) (n=8) Medial leg 87.427.7 91.225.8 (distal) (n=20) Posterior leg 102.348.6 129.644.1 (distal) (n=15) Lateral leg 94.823.6 109.218.3* (distal) (n=22)

921.5194.3* 1,144.0156.2 981.6148.2 1,013.4307.2 1,118.5178.1 1,331.9333.5

P<0.05

Table 7. Comparison of skin thickness between races (Caucasian values taken from Southwood [6] and Artz et al. [1]) Body region Epidermis (lm) Caucasian Southwood Artz et al. Chest Back Abdomen Medial arm Lateral arm Medial forearm Lateral forearm Medial thigh Lateral thigh Posterior thigh Medial leg Lateral leg Posterior leg Mean 44 66 41 42 50 52 55 54 57 57 55 58 58 53.0 39 62 40 44 49 48 53 47 60 64 50 60 63 52.2 Korean Lee 98 76 79 69 83 74 102 87 94 102 91 109 129 91.8 Dermis (lm) Caucasian Southwood Artz et al. 1,400 1,805 1,640 956 1,346 994 1,060 1,104 1,357 1,156 1,030 1,077 1,183 1,148.1 1,319 1,911 1,492 1,027 1,134 995 953 1,059 1,150 1,176 1,119 1,009 1,264 1,200.6 Korean Lee 1,337 1,941 1,248 943 1,030 1,123 1,077 1,058 1,217 1,006 921 1,013 981 1,145.8 E/(E+D)100 (%) Caucasian Southwood Artz et al. 3.1 3.5 2.4 4.2 3.6 5.0 4.9 4.7 4.0 4.7 5.1 5.1 4.7 4.2 2.9 3.14 2.6 4.1 4.1 4.6 5.3 4.3 5.0 5.2 4.3 5.6 4.8 4.3 Korean Lee 6.8 3.7 6.0 6.8 7.5 6.2 8.7 8.2 7.2 9.2 9.0 9.7 11.6 8.3

which make them a less than ideal donor site for splitthickness skin grafts. It should be remembered that thick and thin apply to the epidermis only and not to the skin as a whole [4]. In contrast to the general concept presented in histology textbooks [4], we found that there was no signicant dierence in the epidermis or dermis between exor and extensor surfaces, with the exception of just one region: the epidermis of the extensor surface of the forearm was thicker than that of the exor surface. Dermal thickness in Caucasians and Koreans is very similar, but the epidermis accounts for 8.3% of the depth of the whole skin in Koreans whereas in Caucasians it accounts for only 4.14.2%. Split-thickness skin grafts are divided into thin, medium, and thick grafts. In thin grafts, the thickness of harvested skin ranges from 202 to 305 lm. In medium grafts, the skin thickness is 305457 lm [5]. The subjects used for this classication were all Caucasians. In the posterior thigh, a frequently used donor area for split-thickness skin grafts, the epidermis is about 60 lm thick in Caucasian, but more than 100 lm in Koreans (Table 7). In thin grafts of

202 lm, the epidermis accounts for about 50% in Koreans, but only 30% in Caucasians. These dierences have led us to revise the classication of split-thickness skin grafts in Asians. Men have thicker skin than women in 12 regions. The dierence between skin thickness in Caucasian men and women is similar to the dierence in Koreans [1, 5, 6]. Knowledge of skin thickness may be useful in harvesting full- or split-thickness skin grafts or selecting cutaneous free aps to perform specic reconstructions of several dierent defects in the body.
Acknowledgment We would like to thank Dr. Robert S. Chung, M.D., F.A.C.S., Chungs Institute of Plastic Surgery, Seoul, Korea, formerly Professor and Chief, ASAN Medical Center, Seoul, Korea, for reviewing this article. We are also grateful to Kyan Hyan Yoon, B.A., Medical artist for his beautiful illustration. This study was supported by a grant from Inha University (INHA Research Grant-2001).

References
1. Artz CP, Moncrief JA, Pruitt BA Jr (1979) Burns: a team approach. Saunders, Philadelphia, pp 2444

189 2. Barker DE (1951) Skin thickness in the human. Plast Reconstr Surg 7: 115116 3. Bloom W, Fawcett DW (1975) A textbook of histology, 10th edn. Lippincott, Philadelphia, pp 563594 4. Ham AW, Cormack DH (1987) Histology, 9th edn. Lippincott, Philadelphia, pp 457458 5. Rudolph R, Fisher JC, Ninnemann JL (1980) Skin grafting. Little Brown, Boston 6. Southwood WFW (1955) The thickness of the skin. Plast Reconstr Surg 15: 423429 7. Upham E, Landauer W (1935) The relation of thickness of cutis and subcutis to hair slope in human skin. Anat Rec 61: 359364