Aims Wound closure To prevent infection To recover skin function/reconsruct
DefinitionsGraft 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.
Graft vs Flap Graft FlapDoes not maintain Maintains original bloodoriginal blood supply. supply.
Reconstructive ladder Free flap Distant flap Local flap Full thickness skin graft Split graft Primary closure Secondary intention
Type of Graft Advantages Disadvantages -Best Survival -Least resembles original skin.Thin Split -Heals Rapidly -Least resistance to trauma.Thickness -Poor Sensation -Maximal Secondary Contraction -More qualities of normal -Lower graft survivalThick Split skin. -Slower healing.Thickness -Less Contraction -Looks better -Fair Sensation -Most resembles normal -Poorest survival.Full skin. -Donor site must be closedThickness -Minimal Secondary surgically. contraction -Donor sites are limited. -Resistant to trauma -Good Sensation -Aesthetically pleasing
Auto graft-no rejectionHomo graft-rejected in 3 weeksHetero graftSkin cultureMeshed skin
Skin flap Random pattern Axial pattern flap flap specific artery andsub dermal plexus vein
Skin flap Local flaps transpositio Free flaps Distant flaps nal flap, blood vessels groin flap, rotation dissected and cross leg flap, anastamosed flap, to the pedicle flap z plasty, recipient area v/y plasty