What is a split-thickness skin graft



As Split skin a skin graft is used to cover skin defects such as burns, chemical burns, chronic ulcers or wounds.

With the dermatome (hand dermatome, compressed air dermatome or electrodermatome) or a scalpel, a flap between 0.2 and 0.6 mm thick from different layers of the epidermis and dermis is removed and used to cover the defect. The sampling point is typically a healthy area of ​​skin on the thigh or other area normally covered by clothing. An infection-free, granulating wound is a prerequisite for the success of the split-thickness skin graft.

Mesh graft

If larger defects have to be covered, the obtained graft can be removed using the technique of the Mesh graft (Mesh graft) can be provided with a diamond-shaped cutting pattern on a knife roller and thus cover an area up to three times as large due to the possible stretching. At the same time, this procedure has the advantage that wound exudate can drain through the openings in the transplant.

Meek graft

If even larger areas need to be covered (e.g. for severely burned people), the technology of the is used Meek graft (named after the first descriptor C.P. Meek). The split skin removed is pulled onto cork sheets and then cut into squares about 2x2 millimeters with the help of rotating blades. These are applied to special one-time stretchable textiles and then pulled apart up to a ratio of a maximum of 1: 6. These textile pads are then applied to the wound and anchored.

Follow-up

After initially covering the extraction point with vaseline bandages or the like, the infection-free wound can be air-dried and treated like a deep abrasion. The complete cutting out of the removal points that are not too wide and the subsequent seam has also proven successful. As after other operations, the healed scar is narrow and mostly barely visible. In the case of large extraction points, you can also use a transparent film such as Omnidermwhich is gradually removed over the regrown skin. The dressing changes are almost unnecessary and are much less painful. At the graft site, the bandages are often used to apply slight pressure in order to ensure that the granulation tissue can grow into the vessels. At the same time, the wound is immobilized for a few days in order to avoid disruptive movements between the graft and the wound bed.

Complications

If the graft is rejected, infection is often the cause. Healing disorders also arise with poor local blood circulation and when the split-thickness skin graft is not applied tension-free and therefore does not lie sufficiently on the wound bed.

See also

Leg ulcer, keloid, compartment syndrome

Category: surgery