Professional Documents
Culture Documents
Outline
1. Skin Review
2. Definition
3. Classification of Skin Grafts
4. Types of Skin Grafts (according to depth)
5. Indications for Grafts
6. Donor Sites
7. Harvesting Tools
SKIN
EPIDERMIS DERMIS
Skin
EPIDERMIS
• No blood vessels.
Allograft Allograft
Xenograft
Types of Grafts
Grafts are typically described in terms of thickness or depth.
Fibrin adhesion
pink graft
Skin Grafts: “Process of Take”
Revascularization & fibrous attachment:
Connection of graft & host vessels via anastomoses (inosculation)
Sheet Graft
Joint
Advantages Hands
Lager area face
Contours irregular surface
Drain blood & exudates
Increase edges_______reepithilialization
Disadvantages
Much of wound heal 2*______contracture
Cobble stone appearance
Skin Graft Survival
Atraumatic graft handling
Haemostasis
Immobilization
Sepsis
Medications
Steroids
Antineoplastic agents
Vasonconstrictors (e.g. nicotine)
• INDICATIONS OF SKIN GRAFT:
• 1-Skin loss:
• - Post –traumatic
• - Post surgical
• - Extensive burn
• 2- Mucosal loss:
• - vaginal a genesis
• Contraindications:
1- Avascular recipient areas :
- Cortical bone without periosteum
- Cartilage without perichondrim
- Tendon without paratenon
2- Infection :
a- heavily infected wound with copious discharge(100 000
bact./ gram of tissue).
b- Infection by Beta haemolytic streptococcus
Donor Sites
The ideal donor site would provide skin that is
- Colour
- Thickness
- Hair
- Texture
Donor Sites
Donor site for FTG
Post auricular skin
Upper eyelid skin
Supraclavicular skin
Flexural skin
Thigh and abdominal skin
FTG should be clear of fat
FTG sutured edge to edge while STG overlaps the defect.
Use quilting / tie over
Harvesting Tools
Razor Blades
Grafting Knives (Blair, Ferris, Smith, Humbly, Goulian)
Manual Drum Dermatomes (Padgett, Reese)
**Electric/Air Powered Dermatomes (Brown, Padgett,
Hall)