← All decks
Dermatology
Grafts
Built from Dermatology, 5th Edition
What’s inside
7 sections · 94 slides
Overview
- Six things this topic covers
Foundations of Skin Grafting
What a free graft is, the four types used in dermatologic surgery, and how one survives
- What a free skin graft is
- A short history of skin grafting
- Four graft types and their main uses
- The four types of free skin graft
- Comparison of graft types used in soft tissue reconstruction
- Comparison of graft types used in soft tissue reconstruction
- Comparison of graft types used in soft tissue reconstruction
- Graft types: indications
- Graft types: contraindications
- Graft types: advantages
- Graft types: disadvantages
- Graft types: disadvantages (continued)
Wound Healing After Grafting
The unique sequence by which a severed piece of skin reconnects and survives
- The first 24 hours: plasmatic imbibition
- From day 2: building a new blood supply
- Recovery of glands, lymphatics and nerves
- Why the ischemic period is fragile
- Patient factors that threaten graft survival
- Causes of graft failure
- Causes of graft failure (continued)
- Causes of graft failure (continued)
- The most common graft infections
Full-Thickness Skin Grafts
The full-color, full-texture graft of choice for visible facial defects
- When a full-thickness graft is used
- Why FTSGs give the best cosmetic match
- Full-thickness skin graft repairing an ear defect
- Preoperative history that matters
- Choosing a donor site by tissue match
- Donor site considerations for full-thickness skin grafts
- Summary of possible full-thickness skin graft donor sites for defects in different locations
- Matching donor skin to specific defects
- Full-thickness skin graft repairing an ear defect: a second case
- Making a template of the defect
- Harvesting and placing a full-thickness skin graft on the nose
- Harvesting and defatting the graft
- Securing the graft to its bed
- The tie-over bolster dressing
- A second worked example: full-thickness graft placement on the nasal tip
- Postoperative wound care
- What graft color tells you
- Short-term complications
- Long-term cosmetic and functional issues
- Purse-string suture: shrinking the defect first
- Burow's grafts: borrowing skin next door
- Deep nasal defects: buying time to heal
- Perichondrial cutaneous grafts
- Looking ahead for full-thickness grafting
Split-Thickness Skin Grafts
A thinner, hardier graft for large defects and sites with a poor blood supply
- What a split-thickness graft carries
- Classification of split-thickness skin grafts
- When a split-thickness graft is chosen
- Trade-offs of a split-thickness graft
- Split-thickness skin grafts on the leg and scalp
- Why an STSG looks like a 'tire patch'
- Choosing a split-thickness donor site
- Freehand harvesting with a blade
- Freehand harvesting of a small split-thickness skin graft
- Harvesting with a power dermatome
- Harvesting a large split-thickness skin graft with a power dermatome
- Securing an STSG to its bed
- Caring for the donor site wound
- Meshing: expanding a graft's coverage
- Postoperative care of the STSG donor site
- Late complications of split-thickness skin grafts
- Color and texture complications
- Contracture: the main functional risk
- Looking ahead for split-thickness grafting
Composite Grafts
Skin fused to cartilage, for repairing full-thickness nasal rim and tip defects
- What a composite graft is used for
- Why composite grafts must stay small
- How a composite graft changes color as it heals
- Donor sites for auricular composite grafts
- Composite graft advantages and disadvantages
- Technique of interlocking composite graft placement
- The tongue-in-groove placement technique
- Aftercare for composite grafts
- Ear-related infection risk with composite grafts
Free Cartilage Grafts
Cartilage alone, used to brace a nose or ear rim against collapse
- Where free cartilage grafts are used
- Nasal alar rim distortion from unsupported scar contraction
- Why the nasal ala needs cartilage support
- Cartilage support elsewhere on the face
- Choosing a cartilage donor site
- Harvesting and placing a free cartilage graft for the nasal ala
- The alar batten graft technique
- Postoperative care of cartilage grafts
- Complications of cartilage grafting
- Engineering new cartilage in the lab
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)