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    Skin Grafting

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    armaan hussain
    This document outlines information about skin grafting presented by Farah Iqbal Lodhi to Dr. Manzar Hassan. It includes definitions of grafts and flaps, classifications of skin grafts, types of grafts according to depth, factors that determine graft survival and failure, donor site selection, and tools used for harvesting grafts. The ideal donor site provides skin matching the recipient area in color, thickness, hair, and texture. Electric and air-powered dermatomes are most commonly used for harvesting full thickness and split thickness skin grafts.

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    Skin Grafting

    Uploaded by

    armaan hussain
    1K views25 pages
    This document outlines information about skin grafting presented by Farah Iqbal Lodhi to Dr. Manzar Hassan. It includes definitions of grafts and flaps, classifications of skin grafts, types of grafts according to depth, factors that determine graft survival and failure, donor site selection, and tools used for harvesting grafts. The ideal donor site provides skin matching the recipient area in color, thickness, hair, and texture. Electric and air-powered dermatomes are most commonly used for harvesting full thickness and split thickness skin grafts.

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    skin grafting

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    This document outlines information about skin grafting presented by Farah Iqbal Lodhi to Dr. Manzar Hassan. It includes definitions of grafts and flaps, classifications of skin grafts, types of grafts according to depth, factors that determine graft survival and failure, donor site selection, and tools used for harvesting grafts. The ideal donor site provides skin matching the recipient area in color, thickness, hair, and texture. Electric and air-powered dermatomes are most commonly used for harvesting full thickness and split thickness skin grafts.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    1K views25 pages

    Skin Grafting

    Uploaded by

    armaan hussain
    This document outlines information about skin grafting presented by Farah Iqbal Lodhi to Dr. Manzar Hassan. It includes definitions of grafts and flaps, classifications of skin grafts, types of grafts according to depth, factors that determine graft survival and failure, donor site selection, and tools used for harvesting grafts. The ideal donor site provides skin matching the recipient area in color, thickness, hair, and texture. Electric and air-powered dermatomes are most commonly used for harvesting full thickness and split thickness skin grafts.

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    ASSIGMENT

    Presented to: Dr. Manzar Hassan


    Topic: SKIN GRAFTING
    By: Farah Iqbal Lodhi
    From: 2nd yr, CC.
    DOW UNIVERSITY OF HEALTH & SCIENCES.
    KARACHI.
    Outline
    1. Skin Review
    2. Definitions
    3. Difference between Grafts & Flaps
    4. Classification of Skin Grafts
    5. Types of Skin Grafts (according to depth)
    6. Indications for Grafts
    7. Donor Sites
    8. Harvesting Tools
    SKIN

    EPIDERMIS DERMIS
    Skin
    EPIDERMIS
     No blood vessels.
     Relies on diffusion from
    underlying tissues.
     Stratified squamous
    epithelium composed
    primarily of keratinocytes.
     Separated from the dermis
    by a basement membrane.
    DERMIS
     Composed of two “sub-
    layers”: superficial papillary
    & deep reticular.
     The dermis contains
    collagen, capillaries, elastic
    fibers, fibroblasts, nerve
    endings, etc.
    Definitions
    Graft
    A skin graft is a tissue of epidermis and varying
    amounts of dermis that is detached from its own
    blood supply and placed in a new area with a
    new blood supply.
    Flap
    Any tissue used for reconstruction or wound
    closure that retains all or part of its original blood
    supply after the tissue has been moved to the
    recipient location.
    Classification of Grafts
    • Autografts – A tissue transferred from
    one part of the body to another.
    • Homografts/Allograft – tissue
    transferred from a genetically different
    individual of the same species.
    • Xenografts – a graft transferred from an
    individual of one species to an individual
    of another species.
    Graft vs. Flap
    Graft Flap
    Does not maintain Maintains original blood
    original blood supply. supply.
    Types of Grafts
    Grafts are typically described in terms of thickness
    or depth.

    Split Thickness: Contains 100% of the epidermis


    and a portion of the dermis. Split thickness grafts
    are further classified as thin or thick.

    Full Thickness: Contains 100% of the epidermis


    and dermis.
    Type of Graft Advantages Disadvantages
    -BestSurvival -Least resembles original
    Thin Split
    -Heals Rapidly skin.
    Thickness -Least resistance to trauma.
    -Poor Sensation
    -Maximal Secondary
    Contraction
    -More qualities of -Lower graft survival
    Thick Split
    normal skin. -Slower healing.
    Thickness -Less Contraction
    -Looks better
    -Fair Sensation

    -Most resembles -Poorest survival.


    Full normal skin. -Donor site must be closed
    Thickness -Minimal Secondary surgically.
    contraction -Donor sites are limited.
    -Resistant to trauma
    -Good Sensation
    What factor determines the degree
    of primary contraction?

     The amount of primary contraction is


    directly related to the thickness of dermis
    in the graft.
    The Process of Take
    Phase 1 (0-48h) – Plasmatic Imbibition
    Diffusion of nutrition from the recipient bed.
    Phase 2 – Inosculation
    Vessels in graft connect with those in recipient
    bed.
    Phase 3 (day 3-5) – Neovascular Ingrowth
    Graft revascularized by ingrowth of new vessels
    into bed.
    Requirements for Survival
     Bed must be well vascularized.
     The contact between graft and recipient
    must be fully immobile.
     Low bacterial count at the site.
    Other Factors that Contribute to
    Graft Failure
    Systemic Factors
     Malnutrition
     Sepsis
     Medical Conditions (Diabetes)
     Medications
     Steroids
     Antineoplastic agents
     Vasonconstrictors (e.g. nicotine)
    What are unsuitable sites for
    grafting?
     Bone
     Tendon
     Infected Wound
     Highly irradiated
    Indications for Grafts
     Extensive wounds.
     Burns.
     Specific surgeries that may require skin
    grafts for healing to occur.
     Areas of prior infection with extensive skin
    loss.
     Cosmetic reasons in reconstructive
    surgeries.
    Split Thickness
    Used when cosmetic appearance is not a
    primary issue or when the size of the
    wound is too large to use a full thickness
    graft.

    1. Chronic Ulcers
    2. Temporary coverage
    3. Correction of pigmentation disorders
    4. Burns
    Full Thickness
    Indications for full thickness skin grafts
    include:
    1. If adjacent tissue has premalignant or malignant
    lesions and precludes the use of a flap.
    2. Specific locations that lend themselves well to
    FTSGs include the nasal tip, helical rim,
    forehead, eyelids, medial canthus, concha, and
    digits.
    Donor Sites
    The ideal donor site would provide skin that is
    identical to the skin surrounding the recipient area.
    Unfortunately, skin varies dramatically from one
    anatomic site to another in terms of:

     - Colour
     - Thickness
     - Hair
     - Texture
    Donor Site Selection

     What would be the best donor site for a graft of


    the cheek?
    Donor Site Selection

    A donor site above the clavicles


    would provide the best color
    and texture match. In particular
    the postauricular area is a good
    choice.
    Harvesting Tools
     Razor Blades
     Grafting Knives (Blair, Ferris, Smith, Humbly,
    Goulian)
     Manual Drum Dermatomes (Padgett, Reese)
     **Electric/Air Powered Dermatomes (Brown,
    Padgett, Hall)

    Electric & Air Powered tools are most commonly used.


    Padgett Dermatome
    Goulian Blade
    ??Questions??

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