SKIN GRAFT & IT VARIOUS TYPES OF APPROACH

ACADEMIC PURPOSE OF TEACHING

1. DR.A.S.SHIVA SARAVANAN,M.D,PH.D(HOM)
PROFESSOR &HOD
DEPARTMENT OF SURGERY
VMHMC&H
SALEM
SKIN GRAFT

2. ANATOMY
Epidermis – provide protective barrier against-
mechanical damage, microbe invasion ,water loss
Dermis –mechanical strength,
sensation ,thermoregulation

4. A skin graft is a sheet of skin that is detached from
its own blood supply and placed in a new area of the
body
To provide permanent skin replacement which is
supple sensate and durable.
Function – biologic cover ,thermoregulation,

6. TYPES OF SKIN GRAFT
Autograft
Allograft
Xenograft
Full thickness skin graft
Split thickness skin graft
Composite skin graft
Artificial skin graft
Pinch skin graft
Pedicle skin graft

7. Autograft – skin graft is obtained from another part
of your body that is undamaged and healthy
Allograft – skin graft is obtained from a donor who is
preserved and frozen and made avilable for use when
needed .allograph is usually used as temporary
skingrafts.

9. Xenograft – skin graft is obtained from an animal
usually a pig are called xenograft.
Full thickness skin graft – this type of skin grafts
involves both the layers of the skin that is epidemis
and dermis.
Split thickness – this type of skin graft involves using
the superficial layer that is the epidermis and a small
portion of the dermis.

10. Composite skin graft – this type of skin graft is made
up of a combination of tissues that is skin and either
fat or cartilage ,or only dermis and fat.
Artifical skin graft – this type of skin graft consists of
a synthetic epidemis and a collagen based whose
fibers are arranged in lattice.

11. Pinch skin graft – small pieces of skin are placed to
cover the damaged skin on the donor site. The pinch
skin grafts usually grow even in areas of poor blood
supply and resist infection.
Pedicle skin graft – the skin graft from the donor site
will remain attached to the donor area and the
remainder is attached to the recipient site. The blood
supply remains intact at the donor location and is
not cut loss until the new blood supply has
completely developed.

13. Pathophysiology
Neovascularisation and revascularization
Formation of new vascular channels
Combination of old and new vessels
Fibroblast proliferation
Collagen linkage

14. Vascular inosculation
After 48 hours
Fine vascular network in the fibrin layer
Capillary buds make contact with the graft
Blood flow is established
Skin graft becomes pink

15. Plasmatic imbibitions
Initial graft ischemia
Fibrin adhesion
Grafts gain weight

16. Factors affecting grafts take
Graft factors
Graft bed factors
Environmental factors
Immunological factors

18. Environmental factors
Pressure
mobilization

19. Intraoperative
Cleaning and draping
Harvesting
Graft preparation
Dressing
The graft is harvested by applying steady pressure to
the skin with the dermatome while advancing it
forward. The assistant retracted the skin to optimize
contact between blade and skin.

20. Preoperative preparation
Consent
Haemogram
Plain radiograph
Wound m/c/s
Antibiotics

21. complication
Donor site morbidity
Graft loss
Hyperpigamentation
Poor cosmesis
Unhealthy granulation tissue
Streptococcal infection