THE SURGICAL PRINCIPLES OF SPLIT-THICKNESS-SKIN GRAFTING

¹ Department of Orthopaedic Surgery, State University of Iowa, Iowa City

1. The split-thickness graft offers a Wide range of usefulness, and, witlm average skill and a reasonable amount of diligence to the details involved, it is easily obtained by the average surgeon with the Padgett-Hood dermatonme.

2. Three types of wounds requiring split-thickness grafts must be recognized: the early traumatic wounds, the aseptic wounds caused by the excision of a scar, and the granulating wounds. Each requires different management. Early traumatic and aseptic wounds may be considered clean and dressed dry; the granulating wound or the late traumatic wound must be considered infected and unclean, and must be dressed with moist pressure dressings.

3. Newer methods in the handling of the split-thickness grafts must be measured by the yardstick of sound surgical principles. With these principles there can be no compromise.

4. Skin-grafting to resurface lost integunment for the correction of contractures, and to supply adequate coverage for weight-bearing surfaces and areas exposed to trauma, may come in the field of the orthopaedic surgeon. The procedure requires infinite attention to multitudinous details in preparing the recipient area; the obtaining of the graft of a desirable thickness; perfect hemostasis; the maintenance of normal tissue tension; the prevention of tenting; the close application of a voluminous pressure dressing; and the utmost gentleness.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?