Skin grafting is a type of transplant surgery involving skin transplants. The transplanted network is called skin graft .
Skin grafting is often used to treat:
- Extensive injuries or trauma
- Burn
- Extensive areas of skin loss due to infections such as necrotizing fasciitis or purpura fulminans
- Special surgery that may require a skin graft for healing to occur - usually the removal of skin cancer
Skin grafts are often used after serious injuries when some body skin is damaged. Surgical removal (excision or debridement) of damaged skin followed by skin grafting. The transplant serves two purposes: reducing the necessary care (and time at the hospital), and improving the function and appearance of the body area receiving the skin graft.
There are two types of skin grafts, the more common type is where thin layers are removed from healthy body parts (donor parts) such as peeling potatoes, or full thick skin graft, which involves pinching and cutting the skin from the donor portion. A full thick skin graft is more risky, in that the body receives the skin, but leaves only the scar on the donor section, similar to a cesarean scar. For a full thick skin graft, the donor section will often heal much faster than the injury and less painful than the partial thickness skin graft.
Video Skin grafting
Medical use
Two layers of skin made from animal sources have been found useful in venous leg ulcers.
Maps Skin grafting
Estimated taxonomy
- Autologous : The donor skin is taken from a different site on the same individual body (also known as autograft ).
- Isogeneic : Individual donors and receivers are genetically identical (eg, monozygotic twins, animals of a single inbred strain; isograft or syngraft ).
- Allogeneic : Donors and recipients are of the same species (human-> human, dog-> dog; allograft ).
- Xenogeneic : Donors and recipients are distinct species (eg, cattle cartilage; xenograft or heterograft ).
- Prosthetics : Missing tissues are replaced with synthetic materials such as metals, plastics, or ceramics ( prosthetic implants ).
Graft classification
Skin grafts can:
- Split-thickness
A split-thickness skin graft (STSG) is a skin graft including the epidermis and part of the dermis. Its thickness depends on the location of the donor and the needs of the person receiving the corruption. It can be processed through a skin mesher that makes a hole into the graft, allowing it to extend up to nine times its size. Split-thickness grafts are often used because they can cover large areas and low autorejection rates. The same site can be harvested again after six weeks. The donor site heals by re-epithelization of the dermis and surrounding skin and requires dressing.
- Full thickness
A full thick skin graft comprises the epidermis and the entire thickness of the dermis. The donor site is seams covered directly or covered by a split-thickness skin graft.
- Combined Composite
A composite graft is a small transplant containing the underlying skin and cartilage or other tissues. Donor sites include, for example, the skin of the ear and cartilage to reconstruct the defects of the nasal rim.
Donor selection
When grafts are taken from other animals, they are known as heterografts or xenografts. By definition, they are temporary biological clothes that will be rejected by the body in a few days to several weeks. They are useful in reducing bacterial concentration from open wounds, as well as reducing fluid loss.
For a wider tissue loss, a full-thickness skin graft, which covers the entire thickness of the skin, may be necessary. This is often done for deformities on the face and hands where graft contraction should be minimized. The general rule is that the thicker the graft, the less contraction and deformity.
Procedure of cultured cell epithelial autograft (CEA) takes skin cells from people who need a graft to grow new skin cells in laboratory sheets; because the cell is taken from that person, the person's immune system will not reject it. But because these sheets are very thin (only a few thick layers of cells) they are not resistant to trauma, and "take" is often less than 100%. The newer transplant procedure combines CEA with a dermal matrix for further support. Research is investigating the possibility of combining CEA and dermal matrices in a single product.
The experimental procedure is being tested for burn victims using stem cells in a solution applied to the burned area using skin cells. Recent advances have successfully implemented cells without damage.
To remove thinner and thin strips and grooming from donors, the surgeon uses a special surgical device called a dermatome. This usually results in a split-thickness skin graft, which contains the epidermis with only a portion of the dermis. The dermis left in the donor site contains hair follicles and sebaceous glands, both containing epidermal cells that gradually proliferate to form new epidermal layers. Donor sites may be very painful and prone to infection. There are several ways to treat pain at donor sites. These include subcutaneous anesthetic agents, topical anesthetic agents, and certain types of wound dressings.
The graft was carefully spread in an empty area to be closed. It is held in place by several small stitches or surgical staples. Graft was initially nourished by a process called plasmatic imbibition in which the "plasma drinking" graft. New blood vessels begin to grow from the receiving region into the transplanted skin within 36 hours in a process called capillary incubation . To prevent the accumulation of fluid under a graft that can prevent attachment and revascularization, the graft is often connected by making short, long-cut lines cut off, each several millimeters long, with each row offset by half the length of the piece like a brick on the wall. In addition to allowing for drainage, this allows the graft to stretch and cover larger areas as well as to get closer to the contours of the receiving area. However, it produces a slightly wrinkled appearance on healing that may end up looking less aesthetic.
An increasingly common aid for preoperative wound care and postoperative graft healing is the use of negative pressure pressure therapy (NPWT). This system works by placing part of the foam that is cut to the size above the wound, then put the hollow tube into the foam. This arrangement is then secured by bandages. The vacuum unit then creates a negative pressure, seals the wound edges to the foam, and releases excess blood and fluid. This process usually helps maintain cleanliness at the graft site, improves the development of new blood vessels, and increases the chances of graft taking. NPWT can also be used between debridement and graft surgery to assist infected wounds in the net residue for a period of time before new skin is applied. Skin grafting can also be seen as a skin transplant.
Risk
The risks for skin graft surgery are:
- Bleeding
- Infection
- Loss of grafted skin
- Nerve damage
- Graft-versus-host disease
Rejection can occur in xenografts. To prevent this, people who receive a graft usually have to be treated with long-term immunosuppressant drugs.
Prognosis
Most skin grafts are successful, but in some cases the graft does not heal well and may require repeated transplantation. Graft should also be monitored for good circulation.
The recovery time of the skin graft can be long. Graft recipients wear compression clothing for several months and are at risk for depression and anxiety due to pain and loss of long-term function.
History
The first skin grafts were performed in India in the first century. In the most basic sense, skin grafting is a skin grafting and, occasionally, another underlying tissue type to another location of the body. The technique of skin transplant and transplant was initially described about 2500-3000 years ago with the Hindu Tilemaker Cage, where the skin grafts were used to reconstruct the amputated nose as a means of judicial punishment. [1] The use of more modern skin grafts was described in the mid-19th century, including the use of transplants in 1869 by Reverdin; [2] Ollier and Thiersch used split-thickness grafts in 1872 and 1886, respectively; [3, 4] and Wolfe and Krause used full thickness graft in 1875 and 1893, respectively. [5] Currently, skin grafts are commonly used in dermatology surgery.
References
External links
- Skin graft. MedlinePlus Medical Encyclopedia. This part of the US Federal Government public domain text is used in the article.
- Introduction to the use of vacuum-assisted closure.
Source of the article : Wikipedia
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