Skin grafting involves harvesting skin from a donor site and transferring it to a recipient site lacking adequate skin coverage. There are two main types of skin grafts - split thickness skin grafts (STSG) which transfer some of the epidermis and dermis, and full thickness skin grafts (FTSG) which transfer the entire skin layer. The recipient site must be properly prepared and grafted dermis side down. Grafts are secured and cared for until neovascularization occurs within 4-7 days. Factors like infection, poor wound healing, or graft movement can lead to graft failure. Skin grafting is commonly used to treat burns, wounds, and skin defects from trauma or cancer.
A presentation
a. The anatomy of the skin
b. The types of skin grafts
c. Indications of a skin graft
d. Mechanism of a graft take
e. Causes of graft failure
f. How to perform skin grafting
Cheek Fillers|Facial Aesthetic| Facial Aesthetic by Dr Rajat Sachdeva| Facial...Dr. Rajat Sachdeva
Cheek Fillers rejuvenate the cheeks and to regain last volume.
Autologous Fat Injection, where your own fat harvested from some other area can be used to restore volume of cheeks.
Some other fillers like Hyaluronic acid, Ca Hydroxide and Polymethyl Metacrylate are injected with fine needles in the target area eliminate wrinkles and enhances cheeks volume.
A presentation
a. The anatomy of the skin
b. The types of skin grafts
c. Indications of a skin graft
d. Mechanism of a graft take
e. Causes of graft failure
f. How to perform skin grafting
Cheek Fillers|Facial Aesthetic| Facial Aesthetic by Dr Rajat Sachdeva| Facial...Dr. Rajat Sachdeva
Cheek Fillers rejuvenate the cheeks and to regain last volume.
Autologous Fat Injection, where your own fat harvested from some other area can be used to restore volume of cheeks.
Some other fillers like Hyaluronic acid, Ca Hydroxide and Polymethyl Metacrylate are injected with fine needles in the target area eliminate wrinkles and enhances cheeks volume.
A skin graft is a surgical procedure in which a piece of skin is transplanted from one area to another. Often skin will be taken from unaffected areas on the injured person and used to cover a defect, often a burn.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
2. Trauma, infection, or surgery
Sutures or staples for wound closure
Skin graft for full thickness abrasions
Introduction
3. A skin graft is the transfer of skin from a donor
site to a recipient site.
Lacking blood supply
Surviving by plasmatic imbibition
Neovascularization: over 48 to 72 hours
Full circulation: within 4 to 7 days
Skin Grafts
4. Types of skin grafts
Split thickness skin grafts (STSG)
Full thickness skin grafts (FTSG)
Some of the underlying dermis
The whole epidermis layer
A portion of skin
The entire layer of skin
5. How to choice?
Sites FTSG STSG Reason
Face
Minimal
contraction
Large defects of the trunk A smaller
area of
scarring
Extremities away from joints
Areas of mobility (Joints) Functional
benefits of
minimal
contraction
Functionally crucial areas
(Finger tips)
6. Donor site selection
i. Desired color, texture and thickness
ii. Inconspicuous areas
Recipient site preparation
i. Well vascularized
ii. Free of all necrotic or ischemic tissue
iii. No accumulation of blood or fluid
Surgical technique
7. How is a skin graft done?
Harvest
Graft meshing
Graft inset
Recipient site care
Donor site care
8. Harvested from healthy donor site with dermatome
Tension skin with mineral oil
Harvest
9. Perforated using a skin graft mesher.
Improvement of coverage, drainage and healing of skin
Graft meshing
11. Negative pressure wound therapy:
The foam insert (sponge) is covered by a clear, vapor
permeable, plastic dressing.
Continuous subatmospheric pressure causes fluid to flow out of
the wound.
Recipient site care
13. 3 to 6 months to mature.
Graft maturation
Smooth but inconsistent in color
Erythematous and irregular
14. Graft movement
Comorbidities:
diabetes, smoking, protein or vitamin deficiencies.
Infection:
Methicillin-resistant coagulase-positive
staphylococci (MRSA), β-hemolytic
streptococcus, or pseudomonas
Graft failure
15. The routine use of grafts improve outcomes and quality
of life for trauma patients, burn patients, and cancer
patients
A skin graft is a transfer of skin from the donor site to
the recipient site without the benefit of any blood
supply.
STSG transfer a portion of the donor site skin layer
including the epidermis and some of the underlying
dermis.
FTSG harvest the entire layer of skin as the graft.
Proper preparation of the recipient site is crucial.
Pearls
16. References
1. Ratner D. Skin grafting. Semin Cutan Med Surg 2003; 22:295.
2. Ogawa R, Hyakusoku H, Ono S. Useful tips for successful skin grafting. J Nippon
Med Sch 2007; 74:386.
3. Harrison CA, MacNeil S. The mechanism of skin graft contraction: an update on
current research and potential future therapies. Burns 2008; 34:153.
4. Dirschl DR, Wilson FC. Topical antibiotic irrigation in the prophylaxis of operative
wound infections in orthopedic surgery. Orthop Clin North Am 1991; 22:419.
5. Ratner D. Skin grafting. From here to there. Dermatol Clin 1998; 16:75.
6. Housewright CD, Lenis A, Butler DF. Oscillating electric dermatome use for
harvesting split-thickness skin grafts. Dermatol Surg 2010; 36:1179.
7. Currie LJ, Sharpe JR, Martin R. The use of fibrin glue in skin grafts and tissue-
engineered skin replacements: a review. Plast Reconstr Surg 2001; 108:1713.
recalcitrant lower extremity ulcers. Dermatol Surg 2010; 36:453.
8. Scherer LA, Shiver S, Chang M, et al. The vacuum assisted closure device: a
method of securing skin grafts and improving graft survival. Arch Surg 2002; 137:930.
