Skin 2 Flashcards
Tiss detached from 1 area of the body and transferred to recipient area w/o terminating the vascular attachment
Skin Flaps
Skin flaps are used to
cover poor vascular wound beds, provide padding, cover wounds w/ cartilage and bone
Skin grafting is really
an organ transplant
Living tissue (skin graft) transplanted from same person
Autograft (ideal)
Heterograft
temporary graft from another species
Xenograft
aka heterograft
(x) cross species
Temporary
Homograft
From Cadaver
The thinner the graft…
the better the take
The thicker the graft
the better the function
Full thickness grafts contain
epidermis and dermis (trimmed sub-cu)
Full thickness grafts are best for
areas of flexion and small facial wounds
able to withstand trauma, more aesthetically pleasing
Split Thickness Grafts
epidermis & PORTION of the dermis
Advantages of Split Thickness Grafts
become vascularized more rapidly
May be meshed
Complications of Split Thickness Grafts
Post graft contracture (skin shrinks as it heals)
Look least like normal skin
Less resistant to trauma
Dermatome
used for removing split thickness skin grafts from donor site
Split Thickness Meshed Graft advantages/ uses:
Enlarged graft (stretching up to 4x original sz)
Allows blood & secretions to drain (prevents hematoma)
Prevents Graft Loss
Split Thickness Meshed Graft disadvantages:
Longer to heal, less durable, scarring
Nursing care of the donor site
dressing, watch for infection, pain control
How many hours must the Pressure Garment be worn for a skin graft?
23h/day for 12-18mos
What is the purpose of a pressure garment (2)
Minimize scarring
Place pressure on skin that skin normally puts on itself when healing
Disadvantage of Skin Grafting
Donor site is painful Increased infection risk Scarring Decreased ROM/ Joint Function Color/ Texter Changes (think Milman)
Attempt to reattach a completely amputate digit or body part
Microsurgical Replantation
Goal of Microsurgical Replantation
Restore function beyond that provided by prosthesis
When is revascularization performed on amputations?
When the body part remains attached to body by skin, artery, vein, or nerve.
Time frame for successful replantations
Within 4-6 hrs (has been up to 24h)
Highly depended on SURGEON, surgical team, equipment…..
Best candidates for Microsurgical Replantation
Any part of child
Thumb, digits, palm, wrist, forearm, elbow
Length of Microsurgical Replantation Surgery
10-12h
Microsurgical Replantation Key Notes
Monitor PERIPHERAL VASCULAR & neuromuscular
Post-op PT and pt comfort important
Dermatitis
Inflammatory response of the epidermis
Dilated superficial dermal vessels d/t increased vessel pressure esp of face, neck, legs
Telangiectasia
Bright red papule (solid raised) that blanches with pressure; Round & less than 6 mm; Found on trunk, proximal extremity
Senile/Cherry Angioma
Senile/Cherry Angioma are a possible sign of
Sign of HTN, hepatic disease or infection–> have MD check
Benign tumor of adipose tissue
Lipoma
Large, one-sided brown patch, found on shoulders, upper trunk; Often hairy;
Mostly adolescent males
Beckers Nevus
Lentigo aka
“age spots” or “liver spots”
Lentigo are caused by
Sun exposure & Aging
“Black Mole Cancer”
Malignant Melanoma
Malignant Melanoma arises from
melanocytes
Keobner Phenomenom
New lesions develop following local trauma or skin injury (must reach dermis, includes surgery)
Actinic Keratosis aka
Solar Keratosis
Pre-cursor to SCC
Topical Cytotoxic agent for sun-damaged cells
Fluorouracil (5-FU)
