SKIN GRAFTS

Excess split-skin autografts harvested and meshed during a surgical session are often stored at short-term for later burn surgery or graft failure.

The current procedure in skin graft storage involves wrapping the meshed autograft on a piece of ringer lactate or normal saline-moistened gauze, transferring it into a sterile container and storing it in a 4° C for 2 weeks. The graft should never be totally immersed in saline because it will become macerated. After 14 days of storage the respiratory activity of skin graft reduced by 50%.

Answer is ‘a’ i.e. Muscle:

• A rich vascular supply is essential for support of a split – thickness (or full thickness) graft. It does not survive when placed directly over bone, cartilage or bare tendon.
• For critical & small areas such as an eyelid, a full thickness graft is selected, so that contraction of the grafted material is mimimal.

Ans. is ‘d’ i.e., Post auricular region 

Full thickness skin graft for face is taken from post-auricular region supraclavicular region (Ref: Schwartz 7/e, p 2093)

Ans. is ‘a’ i.e., Streptococcus 

Ans. is ‘c’ i.e., They contract to the same degree as a grafted sheet of skin

Meshed skin grafts are split-thickness grafts cm 7.5

• Meshing can be done using a machine which creates regular slits in the graft, allowing it to be expanded. Thus it can cover larger areas. The slits also allow blood from the wound to escape to the surface, reducing the chances of hematoma and therefore improving graft take.
• Meshed grafts are particularly valuable in burned patients where large areas of skin need to be covered.

Drawbacks of meshed grafts are

– suboptimal appearance

– tendency to contract

Ans. B i.e. Thigh

Skin grafts

• Partial-thickness skin grafts/ Theirsch graft: Consist of epidermis & variable thickness of the dermis
• Full-thickness/ Wolfes graft: Consists of epidermis & all of the dermis
• Composite grafts: Consist of skin & some underlying tissue (fat, cartilage etc.)