Skin Grafts & Biological Skin Substitutes - Class 4

Question 1

skin grafts

Answer 1

split-thickness

full-thickness

Question 2

split thickness

Answer 2

all of epidermis and part of dermis of varying thickness

Question 3

split thickness can tolerate

Answer 3

less ideal conditions

Question 4

when are split thickness skin grafts used

Answer 4

more fxnal than cosmetic reasons

resurface large wounds

Question 5

full thickness skin grafts

Answer 5

all of epidermis and entire thickness of dermis included

Question 6

full thickness skin grafts limited to

Answer 6

small, clean, uncontaminated and well vascularized wounds

Question 7

full thickness donor sites

Answer 7

closed primarily

Question 8

how are skin grafts retrieved

Answer 8

humby knife

power-driven dermatome

Question 9

dressing of graft site must provide

Answer 9

uniform pressure to immobilize graft

Question 10

dressing of graft prevents

Answer 10

shearing

formation of seromas or hematomas under graft

Question 11

types of dressings

Answer 11

bolster w/ xeroform/adaptic

compressive

NPWT

Question 12

how long is a dressing left on

Answer 12

5 days

unless signs of complication

Question 13

interventions for dressing

Answer 13

leg elevation and complete bed rest

Question 14

dressing of donor site

Answer 14

FTSG

STSG

Question 15

FTSG donor site

Answer 15

dressed as other wounds closed primarily

Question 16

STSG donor site

Answer 16

dressings that promote rapid epithelialization

causes little pain

requires little care

inexpensive

low rate of infection

Question 17

STSG examples

Answer 17

occlusive dressings (duoderm)

semi-occlusive (tegaderm)

semiopen dressings (xeroform)

Question 18

graft failure

Answer 18

poor graft contact or adherence to wound bed

hematoma/seroma formation under graft

movement or shearing of graft on wound bed

poor recipient site from poor vascularity

wound infection

technical error (applying graft upside down)

Question 19

biological substitutes

Answer 19

intended for permanent replacement or as a temporary biological dressing

Question 20

biological skin subs decrease ____ and promote _____

Answer 20

bacterial count

promote a sterile wound

Question 21

biological skin subs slow

Answer 21

loss of water, protein and electrolytes

Question 22

biological skin subs reduce

Answer 22

pain and fever

Question 23

biological skin subs restore

Answer 23

fxn

Question 24

biological skin subs –> prevent desiccation

Answer 24

by facilitating early motion

provide coverage of vessels, tendons and nerves to prevent desiccation

Question 25

biological skin subs

Answer 25

allograft/homograft

xenograft/heterograft

epithelial cells

allograft dermis

bilayer collagen matrices

Question 26

allograft/homograft

Answer 26

cadaveric grafts

transplanted w/in the same species

Question 27

xenograft/heterograft

Answer 27

pig skin grafts

one species to another

Question 28

epithelial cells

Answer 28

grown in culture from biopsy sized cultures

Question 29

allograft dermis

Answer 29

not rejected b/c of immunologically inert

can be eventually incorporated

Question 30

bilayer collagen matrices are made of

Answer 30

bovine collagen

Question 31

bilayer collagen matrices act as

Answer 31

scaffold for influx of fibroblasts and blood vessels that eventually replace it

Question 32

bilayer collagen matrices simulates

Answer 32

epidermis to control fluid loss

Question 33

s/p plastic surgery bedrest

Answer 33

complete and strict bedrest x 5 days

Question 34

how long is dressing left in place –> s/p plastic surgery

Answer 34

left in place for 5 days

unless signs of flap failure or graft infection

Question 35

s/p plastic surgery should do

Answer 35

leg elevation

Question 36

POD #5 graft/flap assessment for take

Answer 36

graft take assessed y percentage of adherence

Question 37

ambulation –> s/p plastic surgery

Answer 37

dependent on surgeons orders

OOB –> chair only v. ambulation

weight bearing status

Question 38

WB status –> s/p plastic surgery

Answer 38

dependent on MD

surgical site

Question 39

s/p plastic surgery –> donor site

Answer 39

primary closure

open STSG donor site