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vasoconstriction / vasodilatation
weight.
The skin consists of two main layers:
- The outer layer or epidermis, is derived from ectoderm - The thicker inner layer, or dermis, is derived from mesoderm.
it is thickest on the palms and soles of the feet, and thinnest on the eyelids.
In general, men have thicker skin than women, and
again as it loses its elastic fibers and some of its fluid content.
injury, or surgery.
New cells grow from the graft, covering the damaged
Less than the entire thickness of the dermis is included Split-thickness skin grafts are further categorized based onthe thickness of graft harvested : Thin (0.005-0.012 inches), Intermediate (0.012-0.018 inches), or Thick (0.018-0.030 inches)
- Autogenous grafts or autografts comes from the same individual - Heterogenous grafts comes from sourcesother than the patient himself
surface of the body. Most times, it is an area that is hidden by clothes, such as the buttock or inner thigh.
Full-thickness grafts may be harvested from
bloodsupply.
of tissue occurs.
The essential difference between the two is that a flap
Based on distance in relation to the defect Local flap Raised from tissue immediately adjacent to or very
Based on composition
Simple
Based on blood supply Random pattern flap Derives its nutrition from the dermal-subdermal
plexus
Microvascular free flap Taken free from other parts of the body preserving its
blood supply, and anastomosed to the available blood supplyin the recipient area
after transfer.
Deltopectoral Flap
Trapezius Flap Latissimus Dorsi Flap
Sternocleidomastoid Flap
Forehead Flap
missing skin or to provide a temporary wound covering. This covering is necessary because the skin protects the body from fluid loss, aids in temperature regulation, and helps prevent disease-causing bacteria or viruses from entering the body. Skin that is damaged extensively by burns or nonhealing wounds can compromise the health and wellbeing of the patient.
amount of skin loss Burns Cosmetic reasons or reconstructive surgeries where there has been skin damage or skin loss Skin cancer surgery Surgeries that need skin grafts to heal Venous ulcers, pressure ulcers, or diabetic ulcers that do not heal Very large wounds When the surgeon is unable to close a wound properly
Reactions to medicines
Problems with breathing
Bleeding
Chronic pain (rarely) Infection Loss of grafted skin (the graft not healing, or the graft
healing slowly) Reduced or lost skin sensation, or increased sensitivity Scarring Skin discoloration Uneven skin surface
should be lubricated daily for two to three months with mineral oil or another bland oil to prevent drying and cracking.
The severe pain and lengthy period of recovery
transportation disaster, terrorist attack, or other fire involving large numbers of people, he or she is at high risk of developing post-traumatic stress disorder (PTSD). Doctors treating the survivors of a nightclub fire in Rhode Island in February 2003 gave them anti-anxiety medications within a few days of the tragedy in order to reduce the risk of PTSD.
varies enormously depending on the type, size and situation. A simple split skin graft may take less than an hour, whilst a complicated free flap could last as long as 10 or 12 hours.
Surgical Therapy
harvesting and securing skin grafts; procedures for STSGs and FTSGs vary substantially.
The procedures
also vary among surgeons and circumstances; variations in the tools and techniques of graft harvesting, placement, and care are discussed in Intraoperative details.
grafting.
As
with all dermatologic surgery, thorough preoperative history taking is critical ; the history should include information about the patient's medications (particularly those with anticoagulant properties), allergies, bleeding diatheses, frequent or recurrent infections, and general wound healing.
activities (particularly those involving shearing forces), the patient's ability to care for the wounds (at both the donor and recipient sites), and the surgeon's assessment of the patient's expectations.
Complications include :
under the graft, which interferes with the regrowth of blood vessels, and Infection of the donor site or the wound (recipient) site.