Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Chapter 90 Breast reconstruction after mastectomy
- Chapter 91 Facial rejuvenation
- Chapter 92 Liposuction
- Chapter 93 Facial fractures
- Chapter 94 Flap coverage for pressure ulcers
- Chapter 95 Muscle flap coverage of sternal wound infections
- Chapter 96 Skin grafting for burns
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 96 - Skin grafting for burns
from Section 20 - Plastic and Reconstructive Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Chapter 90 Breast reconstruction after mastectomy
- Chapter 91 Facial rejuvenation
- Chapter 92 Liposuction
- Chapter 93 Facial fractures
- Chapter 94 Flap coverage for pressure ulcers
- Chapter 95 Muscle flap coverage of sternal wound infections
- Chapter 96 Skin grafting for burns
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
A burn injury is essentially an injury to the epidermal and dermal layers of the skin. While the epidermis is rapidly and efficiently repaired in humans, the dermis heals poorly if at all. In burns where most of the dermis is not injured (superficial partial thickness burns), the burn heals rapidly with a cosmetically and functionally acceptable scar. In burns where most or all of the dermis is dead (deep partial thickness or full thickness burns), healing is slow (if at all) and the scarring is severe.
Skin grafting for burns consists of repairing the damaged area of skin by harvesting the top layers of an area of uninjured skin. Top layers of undamaged skin are removed with an instrument called a dermatome. This intervention creates an area of exposed dermis called the donor site. The burned skin is debrided by serially slicing off layers of dead dermis until live tissue is reached in a process called tangential excision. The cutting is parallel (tangential) to the surface of the burn. Tissue bleeding and appearance is used as a sign of viability. The harvested skin is attached (using staples, sutures, or glue) to the excised wound bed; it becomes vascularized over the next 3–5 days. The donor site heals by epithelialization from the hair follicles and sweat glands deep in the remaining dermis.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 649 - 650Publisher: Cambridge University PressPrint publication year: 2013