GRAFTS AND FLAPS

I.SKIN GRAFT

A segment of skin separated completely

from its bed (donor site) and transplanted
to another area (recipient site) from which
it must receive new blood supply
1.By species
a.Autograft- graft from one place to
another on the same person
b.Allograft (homograft)- graft from one
person to another in the same species
c.Xenograft (heterograft)- graft from one
person to another of different species
2.By thickness
a.Split thickness
1.Includes epidermis and part of dermis
2.Some dermal skin appendages(sweat
glands, hair follicles and sebaceous
glands)
3.Thickness varies from thin to thick
a.Percentage of take or survival of the
graft is higher with a thinner graft
b.Shrinkage of the bed onto which the
graft is placed is less with a thicker graft
4.Uses
a.Large areas of skin loss
b.Granulation tissue beds
b.Full Thickness
1.Includes epidermis and all dermis
2.Donor site is full thickness skin loss and
must be closed primarily or split
thickness skin grafted
3.Uses
a.Usually on the face for color match
b.Anywhere that thick skin or less
contraction of the grafted bed is
desired
 II. SKIN FLAP
• Skin and subcutaneous tissue ( in some
cases with muscle and/or bone)
transferred from one site to another with
vasculature maintained for nourishment.

• The “pedicle” is the vascular attachment

A.Classification
1.By vascular pedicle
a.Flap with intact pedicle
1.Cutaneous (random flap)
Blood is supplied through the dermal
and subdermal pleksus
2.Arterial (axial flap)
Blood is supplied by a direct cutaneous
artery and is usually drained by its
accompanying veins
b.Free flap
An arterial flap, in which the vessels are divided,
the flap moved to its new location
and the vessels reanastomosed with
microsurgical techniques to vessel at the
recipient site