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    Physiotherapy Plastic Surgery-120201081443-Phpapp02

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    Nirmaledu Wedge 444
    This document discusses skin grafts and flaps for wound closure and reconstruction. It defines grafts as detached skin with no blood supply, while flaps retain some blood supply. Flaps have advantages over grafts like better survival and resemblance to original skin. Graft types include split thickness and full thickness, with varying advantages and disadvantages. Tools for harvesting include blades and dermatomes. Donor sites consider factors like color, thickness and hair. Other plastic surgeries are also discussed, along with techniques for hand burn assessment and physiotherapy.

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    Physiotherapy Plastic Surgery-120201081443-Phpapp02

    Uploaded by

    Nirmaledu Wedge 444
    56 views18 pages
    This document discusses skin grafts and flaps for wound closure and reconstruction. It defines grafts as detached skin with no blood supply, while flaps retain some blood supply. Flaps have advantages over grafts like better survival and resemblance to original skin. Graft types include split thickness and full thickness, with varying advantages and disadvantages. Tools for harvesting include blades and dermatomes. Donor sites consider factors like color, thickness and hair. Other plastic surgeries are also discussed, along with techniques for hand burn assessment and physiotherapy.

    Original Description:

    Plastic surgery and physical therapy

    Original Title

    Physiotherapy plastic surgery-120201081443-phpapp02

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    © © All Rights Reserved

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    This document discusses skin grafts and flaps for wound closure and reconstruction. It defines grafts as detached skin with no blood supply, while flaps retain some blood supply. Flaps have advantages over grafts like better survival and resemblance to original skin. Graft types include split thickness and full thickness, with varying advantages and disadvantages. Tools for harvesting include blades and dermatomes. Donor sites consider factors like color, thickness and hair. Other plastic surgeries are also discussed, along with techniques for hand burn assessment and physiotherapy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    56 views18 pages

    Physiotherapy Plastic Surgery-120201081443-Phpapp02

    Uploaded by

    Nirmaledu Wedge 444
    This document discusses skin grafts and flaps for wound closure and reconstruction. It defines grafts as detached skin with no blood supply, while flaps retain some blood supply. Flaps have advantages over grafts like better survival and resemblance to original skin. Graft types include split thickness and full thickness, with varying advantages and disadvantages. Tools for harvesting include blades and dermatomes. Donor sites consider factors like color, thickness and hair. Other plastic surgeries are also discussed, along with techniques for hand burn assessment and physiotherapy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 18

    Aims

     Wound closure
     To prevent infection
     To recover skin function/reconsruct
    Definitions
    Graft
    A skin graft is a tissue of epidermis and varying
    amounts of dermis that is detached from its own
    blood supply and placed in a new area with a new
    blood supply.
    Flap
    Any tissue used for reconstruction or wound
    closure that retains all or part of its original blood
    supply after the tissue has been moved to the
    recipient location.
    Graft vs Flap
    Graft Flap
    Does not maintain Maintains original blood
    original blood supply. supply.
    Reconstructive ladder
    Free flap
    Distant flap

    Local flap
    Full thickness skin graft

    Split graft
    Primary closure
    Secondary intention
    Skin graft

    Split thickness
    graft

    Composite Full thickness


    graft(skin+s skin
    ub.cut.tissue graft(epiderm
    ) is+dermis)
    Type of Graft Advantages Disadvantages
    -Best Survival -Least resembles original skin.
    Thin Split
    -Heals Rapidly -Least resistance to trauma.
    Thickness -Poor Sensation
    -Maximal Secondary
    Contraction

    -More qualities of normal -Lower graft survival


    Thick Split skin. -Slower healing.
    Thickness -Less Contraction
    -Looks better
    -Fair Sensation
    -Most resembles normal -Poorest survival.
    Full skin. -Donor site must be closed
    Thickness -Minimal Secondary surgically.
    contraction -Donor sites are limited.
    -Resistant to trauma
    -Good Sensation
    -Aesthetically pleasing
    Auto graft-no rejection

    Homo graft-rejected in 3 weeks

    Hetero graft

    Skin culture

    Meshed skin
    Skin flap

    Random pattern Axial pattern flap


    flap specific artery and
    sub dermal plexus vein
    Skin flap
    Local flaps
    transpositio Free flaps
    Distant flaps
    nal flap, blood vessels
    groin flap,
    rotation dissected and
    cross leg flap, anastamosed
    flap, to the
    pedicle flap
    z plasty, recipient area

    v/y plasty
     Musculo/myo cutaneous flap
    Harvesting Tools
     Razor Blades
     Grafting Knives (Blair, Ferris, Smith, Humbly, Goulian)
     Manual Drum Dermatomes (Padgett, Reese)
     **Electric/Air Powered Dermatomes (Brown, Padgett,
    Hall)

    Electric & Air Powered tools are most commonly used.


    Padgett Dermatome
    Goulian Blade
    Donor Sites
     Color
     Thickness
     Hair
     Texture
    Other plastic surgeries
     Tissue expansion
     Nerve repair
     Nerve grafting
     Nerve transfer
     Neurolysis
     Tendon repair
     Tendon graft
     Tendon tranfer
     Tenolysis
     Toe to hand transfer
     Replantation
    Hand burns
     Subjective examination
     Objective examination
    -observation/palpation
     edema assessment-tapes/rings/callipers&volumetric
    measurements
     Scar assessment-photography,vancouer
    scale(pigmentation,vascularity,pliability&height)
     Circulation
     Nails/skin
     Goniometry/MMT
     Grip strength/hand held dynamometry
     Sensation testing/pain/neurological tests
    Physiotherapy
     Education  Pressure garments
     Wound care  Silicon, coban
     Elevation  Splints
     Active exercise  Thermal
     Passive movements modalities/US/TENS/PEME/
     Stretching NMES
     Strengthening/endurance
     CPM
    exercises
     Neural mobilization
     Motor/sensory re education
     Massage
     Desensitization
     Compression
     Functional training/OT

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