China
Africa
Explore chapters and articles related to this topic
The Host Response to Grafts and Transplantation Immunology
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Skin transplantation is one of the least successful tissue transplant procedures. The reasons for this are unclear. The graft procedure is not technically demanding, and autografts, are usually retained. The failure of foreign skin grafts to be accepted may result from the existence of an usually potent, skin-specific immune response or a unique system of histocompatibility antigens. The need for rapid vascularization of skin and the effect of immunosuppressants on the process of vascularization may also limit skin graft survival.
Burns and burn surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
The split-thickness skin graft donor site is similar to a superficial partial-thickness burn and re-epithelialization can be expected within 2 weeks, depending on the depth of harvest and donor site infection. A number of dressings can be used for the donor sites. The basic dressing should be porous to allow wound exudate and initial postoperative bleeding to exit from the wound surface. The dressings are applied directly on the wound with a few centimeters’ overlap. A suitable absorbent outer dressing is then applied.
Tissue Grafting Techniques
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Ultrathin skin grafting (UTSG) is a special type of split-thickness skin grafting where the skin graft is extremely thin (epidermal) and almost devoid of any dermal tissue, a result of which the harvested graft is translucent in nature. The basic difference between ultrathin and conventional split-thickness skin grafting is the thickness of the graft. Accordingly, split-thickness skin grafts can be of various types (Table 37.2.1) depending upon the thickness of the graft [1]. Though there are many surgical techniques for repigmenting vitiliginous areas, UTSG is simple, with the most rapid onset of pigmentation, in addition to being the most cost-effective procedure. In addition to vitiligo, it can be employed for piebaldism, halo nevi, and for other secondary leukodermas such as post-herpetic, post-burns, post-discoid lupus erythematosus, and contact leukoderma.
Clinical effects of resurfacing fingertip amputations in long fingers using homodigital dorsal neurofascial broaden pedicle island flaps
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Zhongqing Ji, Rongjun Nie, Shiyan Li, Chuancheng Liu, Bin Wei, Chunyong Zhu
The transected digital nerve in the flap was then seamed to the stump of the radial or ulnar proper digital nerve (9-0 Prolene Polypropylene Suture; Ethicon US, LLC, Somerville, NJ) using the epineurium suture method. The flap was sutured with silk thread (5-0 non-absorbable suture, Ethicon US, LLC, Somerville, NJ) starting from the top of the flap (i.e. the opposite side of the broaden pedicle tip), followed by the two sides of the flap. The superficial skin channel was closed after completely suturing the skin flap. When suturing the skin edge near the pivot point, one should ensure that the tension at the skin edge is not too high and that the skin edge on both sides is slightly aligned to guarantee blood supply of the flap due to the existence of a double fascia layer around the pivot point. Finally, direct suture or free skin grafts can be used depending on size of the donor wound based on following principles: a) if the flap width was within 1.0 cm, the donor wound surface can be directly sutured, b) if the flap width is larger than 1.0 cm, free skin graft was appropriate. Forced suture should not be used on either. Typical surgical procedure was shown in Figure 2(A–D).
The Effect of Adipose Derived Stromal Vascular Fraction on Flap Viability in Experimental Diabetes Mellitus and Chronic Renal Disease
Published in Journal of Investigative Surgery, 2022
Burak Özkan, Atilla Adnan Eyüboğlu, Aysen Terzi, Eda Özturan Özer, Burak Ergün Tatar, Cagri A. Uysal
Diabetes mellitus (DM) is still considered one of the leading causes of foot ulcers in the world. Almost one quarter of diabetic patients develop foot ulcers during their life time [1]. The concurrence of diabetes mellitus and chronic renal diseases (CRD) increases the risk of development of diabetic foot compared to diabetic patients with normal renal function. The risk of lower limb amputation in patients with renal failure is 10 times greater than that of diabetic patients without uremia [2]. Reconstruction of chronic wounds in patients with diabetic nephropathy has been a challenge for surgeons due to impaired wound healing capacity and the complexity of the wound itself. Treatment modalities include skin graft, local skin flaps, local or distant muscle or skin flaps. Skin flap surgery is indicated to cover exposed bones or tendons, or to cover deep tissue defects on weight bearing areas under the foot where skin grafts might be thin to withstand the applied pressure by the weight. Success rates in flap surgery are low compared to normal population [3]. Several studies have discussed different strategies to enhance skin flap circulation in diabetic individuals, such as atorvastatin, all-trans retinoic acid and adipose derived stem cells (ADSCs) [4–6].
Negative pressure wound therapy: device design, indications, and the evidence supporting its use
Published in Expert Review of Medical Devices, 2021
Stephen J. Poteet, Steven A. Schulz, Stephen P. Povoski, Albert H. Chao
In reconstructive surgery, skin grafts are commonly used to reconstruct defects. Skin grafts entail harvest of split- or full-thickness skin from a donor site, and subsequent transfer to a defect. The skin graft then heals through a process of revascularization. Prior to revascularization, which typically involves a period of approximately 5 days, a number of factors can interfere with revascularization which can ultimately cause the skin graft to be lost. The formation of any barrier between the skin graft and the recipient wound, such as a hematoma or seroma, can physically obstruct take of the skin graft by the wound. Another factor that can contribute to skin graft failure is shearing and movement of the skin graft relative to the recipient wound. When used as a skin graft dressing, NPWT can serve to mitigate or prevent these processes, whereby continuous suction collects drainage from beneath the skin graft and the dressing itself physically bolsters the skin graft.