Skin Graft

Question 1

What is a skin graft?

Answer 1

A sheet of skin comprising of epidermis and various degree of dermis which has been completely detached from its original site(donor site) and from its blood supply and transplanted to a new site (recipient site) for skin cover and it is expected that the initial survival will depend on diffusion of nutrients and oxygen from the bed to the graft.

Question 2

What are Types of grafts?

Answer 2

Autografts (auto transplantation
) -self
Hetero graft –same specie
Xenografts- different specie

Question 2

TYPES OF SKIN GRAFTS include

Answer 2

Cultured epidermal graft-
Only the epidermis is harvested ,processed with proteolytic enzymes to detatch it from the dermis after which it is grown in a culture broth.
It is used in conjunction with artifical dermis eg integra

Split thickness skin graft(thiersch graft)-
The epidermis and part of the dermis is harvested
Thin, intermediate or thick depending on the dept of the dermis taken.

Full thickness graft (wolfe)-
Contains the epidrmis and the whole of the dermis

Question 2

What is meant by The ‘take’ of a graft?

Answer 2

It is a term used to describe the survival of the grafted skin , and it is given in percentage e.G 50%, 75%

The thinner the graft the easier it is for it to take, but has worse cosmetic appearance after healing, it also under goes more secondary contraction

The thicker the graft the poorer the take but the better the cosmetic appearance, it under goes less secondary contraction

Question 3

What are types of contraction?

Answer 3

Primary contraction –
Is the shrinkage size noticed immidiately the graft is harvest

Secondary contraction is reduction in the size of the graft during wound healing

Question 3

What is the Indication for skin graft?

Answer 3

Wounds with a well vascular bed, including:
Granulation tissue,
Muscles,
Periostium,
Paratenon,
Paraneuron

Question 4

What are the Instruments required for a skin graft?

Answer 4

The instrument used for harvesting a split skin graft is called a skin dermatome

• Hand held or manual : eg humby knife
  -Motorised ; electric or air dermatome

The instrument for mesching a skin graft

Skin graft mescher
Hand mesching

Question 6

What are the Factors that will prevent graft take?

Answer 6

Wrong placement of graft
Tenting of graft over the recipient site
Foreign body
Hematoma
Pus
Infection
Movement of the graft on the bed
Wound infection