Wednesday, May 29, 2019

Indications of skin grafting mnemonic + notes


Indications of skin grafting :

☆ Mnemonic - BITS

1. Burns ( deep, full thickness )
2. Infections ( that cause extensive skin and soft-tissue loss; ex., Necrotizing fasciitis, Diabetic infections )
3. Trauma ( friction burns and degloving injuries )
4. Surgical implications -
       (a) Post-burn release of breast contractions and after reconstruction of local flaps such as transposition/ bipedical flap.
       (b) Excision of a large tumor and reconstruction of the resultant defect.
        (c) Post-OP - Reconstruction of fasciotomy with skin graft, in the compartment syndrome of an extremity, after establishing limb vasculature.

To be noted:

- STSGs are indicated for large Avascular areas, while FTSGs are indicated for small Avascular areas of less than 1 cm., or for larger areas with good blood supply.

- Composite grafts are indicated in situations where a donor site has lost underlying muscle or bone.

- Allografts: for coverage of secondary burns, and an extensive full-thickness burn/ skin loss greater than 30% of body surface; to be changed every three days to avoid rejection response.

- Xenografts: for covering large burn wounds before auto-grafting, and temporary coverage of exposed vessels, tendons, large ulcers, flap donor sites, and skin graft donor sites.

That's all
- Jaskunwar Singh

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