Skin Grafts Essay Research Paper SKIN GRAFTS

Skin Grafts Essay, Research Paper

SKIN GRAFTS Burn Classifications Burns are classified according to the depth of damage to tissues. First-degree burns that in which only the outer layer of skin (the epidermis) is burned. The skin is red and there may be swelling or pain. In second-degree burns, the top layer of skin has been burned through and the second layer of skin (dermis) is also burned. Blisters develop, accompanied by pain and swelling. First- and second-degree burns, typically can be treated with first aid measures at home, but it depends on how large an area and what area of the body is affected. Generally, first- and second-degree burns will heal after a good cleaning and bandaging, and don’t require skin grafting. Extensive third-degree burns, however, usually require treatment at burn care centers. All layers of skin are damaged and sometimes fat, nerve, tendon, muscle, and even bone are affected. Third-degree burns result in open wounds. These wounds must be cleansed and protected to minimize infection. Infection is the leading cause of death among burn patients. Initial treatment of third-degree burns depends on the depth and extent of the burn and the overall health of the patient. There are many kinds of wound dressings for superficial burns. But when burns are deep and cover a large portion of the body, skin grafts are usually necessary (6, pp. 1-4).Overview Skin grafts are layers of skin, which are taken from a suitable donor area of a patient and transplanted to a recipient area of damaged skin. Skin grafts can either be split thickness, a very thin layer or part of the skin or full thickness layers which include all the layers of the skin. Thinner grafts survive transplantation more readily and are more successful. They are used for heavily contaminated surfaces, burn areas, and surfaces with poor blood supply. However they are least like normal skin with loss of suppleness, hair does not tend to grow on them and their final appearance can be a disappointment. Full thickness grafts are more pleasing to the eye, look more like skin, and can withstand a greater amount of trauma once thy are successfully implanted. Meshed grafts allow for a greater degree of covering because the original graft is rolled under a perforating machine and the perforations produced allow for expansion thus increasing the surface area of the graft. Skin grafting is used to replace skin cover. It is used in the treatment of burned areas of skin, varicose ulcers, and after the surgical excision of skin cancers, including malignant melanomas. Infection and lack of satisfactory blood supply prevent some grafts from surviving. A local skinflap is used when the blood supply is poor and it is thought that the area to be grafted will not allow a successful free skin graft. Two areas such as the legs are brought into close proximity and held together by a plaster cast. A flap of skin can be partially removed from the donor area on one leg and transferred over to the recipient area on the other leg. It still retains its blood supply from its connection through the flap with the donor area. There are many variations of skin flaps which use techniques to maintain a blood supply while a potential graph is establishing itself (5, pp. 1).The History of Skin Grafts Tissue transplants have figured prominently in mythology since the legend of the creation of Eve from one of Adam’s ribs. Historical accounts of surgical tissue grafting as part of the cure for patients dates back to the early Hindu surgeons who, about the beginnings of the 6th century BC, developed a technique for reconstructing noses from skin flaps taken from the patient’s arm. This method was introduced into Western medicine by Gaspare Tagliacozzi in the 16th century. The flap was left attached to the arm for two to three weeks until new blood vessels had grown into it from the nose remnant. The flap was then severed and the arm freed from the reconstructed nose. Karl Ferdinand von Grafe (born March 8, 1787) was a German surgeon who helped create modern plastic surgery. A superintendent of German military hospitals during the Napoleonic Wars, he also served as professor of surgery and director of the surgical clinic at the University of Berlin. He improved the English surgeon Joseph Carpue’s adaptation of the “Indian method” and revived the 16th century surgeon Taccacozzi’s “Italian method” of plastic surgery on the nose. The Indian method uses a skin graft from the forehead and the Italian from the upper arm. Grafe also made technical improvements in the administration of blood transfusions (4, pp. 2).Procedure and First AidA skin graft, literally speaking, is taking skin from one area of the body and attaching it another area where no skin exists. The body part involved is the skin (donor and recipient sites). Extensive wounds, burns, or certain surgeries may require skin grafts for healing to occur. There are many things that increase the surgical risk. Adults over sixty are at risk because statistics say that they will probably be in worse health than a younger person and the skin on someone over sixty may have problems such as dryness, less elasticity, and overall health of the skin. Newborns and infants are also at risk because they are more susceptible to infection and have a weak immune system. Obesity, smoking, and poor nutrition also increase the risks of a surgical skin graft because of poor skin elasticity, excessive layers of f