Split Skin (Thiersch) Grafting)
Objective
To cover wounds with loss of skin which cannot be closed by
approximation of skin edges.
Position
Variable according to the site of wound.
Anesthesia
GA (LA can be used for small wounds).
Procedures
1. Clean and drape donor and
recipient areas.
2. Take
skin graft.
3. Prepare
recipient bed by scraping/excision.
4. Secure
hemostasis.
5. Apply
nonadherent gauze.
6. Dressing.
7. Tie
over dressing over trunk. Circumferential pressure dressing over limbs.
8. Splint
the limb with Velroc/Gypsona POP slab.
Instruments
Skin grafting set consisting of:
• Skin
grafting knife (Humby, Blair or Electric dermatome)
• Appropriate
blade of skin grafting knife
• Skin
graft boards (wooden or stainless steel)
• Skin
graft mesher (optional)
• Liquid
paraffin (sterile)
• Vaseline/paraffin
impregnated gauze (Fairly, Jelonet)
• Sterile
cotton soaked in betadine or acriflavin
• Gamjee
pads and crepe bandages
• Adrenalin
in saline (1 in 100,000)
• Syringe
for irrigation
• Velroc
or Gypsona for splinting
• Sutures
3 ‘0’ Nylon/silk on cutting needle.
• 4 ‘0’
chromic catgut on curved cutting needle for children
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