Skin Grafting Flashcards
What are 3 indications for skin grafting?
- Skin defects on the extremities
- Extensive burn wounds
- Adjunct to other reconstructive procedures
What are 3 ways to classify skin grafts based on the donor-host relationship?
- Autograft
- Allograft
- Xenograft
What are 2 ways to classify skin grafts based on thickness?
- Full-thickness
- Split-thickness
What type of recipient bed is preferred in most instances?
Healthy granulation bed
A fresh wound with sufficient what to produce granulation tissue makes a good recipient bed?
Sufficient blood supply
Using cortical fenestration can speed granulation tissue formation over what?
Exposed bone
With cortical fenestration, holes are drilled through the near cortex into what part of the bone?
Medullary cavity
What serves as a matrix for granulation tissue to form on the surface with cortical fenestration?
Blood clots
What are 3 ways to tell when granulation tissue is ready for grafting?
- Granulation tissue is pink and glistening
- Surface is smooth
- Wound contracting and epithelial migration visible at wound margin
What are 3 types of skin grafting techniques?
- Sheet
- Punch
- Strip
What are 3 types of sheet grafting techniques?
- Full-thickness
- Split-thickness
- Mesh, sieve, pie-crust
What are 2 types of punch skin grafting techniques?
- Seed, pinch
- Stamp
What is an example of a strip skin grafting technique?
Tunnel
A full-thickness skin graft consists of what layers of skin?
What are 2 skin elements included in this type of graft?
- Epidermis and dermis
- Hair follicles and adnexal structures
Which type of skin graft results in the best cosmetic appearance and function?
Full-thickness skin graft
When preparing the recipient bed, lightly scrape with a scalpel blade to do what 2 things?
- Remove surface debris
- Expose capillaries
What should the recipient bed be covered with while the graft is being prepared?
Moist sponges soaked in CHX solution
What are 2 reasons for using patterns for skin grafts?
- Recipient sites with irregular borders
- Exact fit is desired
What is the easiest method for harvesting skin grafts?
Dissect graft from donor site deep to cutaneous trunci muscle, remove cutaneous trunci muscle and superficial subcutaneous tissue prior to applying graft.
When preparing a graft, removal of the cutaneous trunci and subcutaneous tissue can be facilitated in what 2 ways to help stretch the graft back to its original size?
- Placing sutures
- Using hypodermic needles
If the graft has been properly prepared, what should be visible?
Bulbs of the hair follicles
What is an important step that enhances revascularization of a graft?
Graft preparation
A sheet graft in which parallel rows of staggered slits are made is known as what?
Mesh graft
What are 3 advantages to mesh grafts?
- Allows expansion of graft to cover larger defects
- Allows drainage of blood and serum from under graft
- Allows graft to conform better to uneven surfaces
The degree to which a mesh graft can be expanded is determined by what 2 factors?
- Number of rows of slits
- Length of each slit
Full-thickness plugs of skin placed in granulation bed is known as what?
Punch (seed) grafts
Are punch (seed) grafts used often in small animals?
No
What do punch (seed) grafts enhance?
Epithelialization
How are punch (seed) grafts placed?
Grafts are press fit into granulation bed but not secured otherwise.
What are 4 things that can be done during post-operative care?
- Apply antibiotic ointment and non-adherent dressing
- Absorbent secondary layer
- Splint or cast if over joint
- Change dressing in 24-48 hours
Which supply is usually re-established faster, arterial or venous?
Arterial
What are 2 common sequelae from post-operative changes seen in healing grafts?
- Venous congestion
- Edema
What are 2 possible occurrences that may take place during the post-operative healing phase?
- Superficial loss of epidermis
- Overgrowth of normal bacteria
