Plastic surgery of the skin

Plastic surgery of the skin is transplantation of skin for closure of large defect - fresh (scalped wound defect after excision of scars or granulating, but healing. Skin plastics are widely used with extensive burns. As a rule, take own skin patients (autoplastika).
Autoplastika produce or free (completely cut off) patches, or flap on the leg. For a free skin plastics are more likely to take the superficial layer of the skin in large patches or small pieces. Method of skin plasty with small pieces of epidermal thickness of 0,3 mm (method Riverdene) has been improved, proposed to take pieces of the epidermis and surface layers of the dermis. Under local anesthesia sharp end of the needle, which is captured hemostatic clip, lift up the flap of skin and cut at the base formed cone. Received a small round piece (0,3-0,5 cm2) on the same needle transplanted to the surface defect tissue, covering all Nude surface either tiled or leaving transplanted between pieces distance of 0.5, see the Wound is covered compress oilcloth with holes for detachable and impose sterile dressing.
Skin plastics large patch of produce according to Tire, however, in addition to the epidermis, and take the superficial layers of the dermis. The operation is done under local anesthesia. The transplant is usually excised sharp razor. More often for taking large pieces are dermatome. The skin (usually on the outside of the thigh) glue and gauze is fixed to the roller dermatome; if the rotation of the tool handle the skin is pulled, as it cut off the blade. Dermatome sterilized disassembled by boiling, and the blade to alcohol.
When the plastic skin stalked flap Filatov (migratory graft or flap on a round leg) flap is cut out two parallel incisions in the entire thickness of the skin away from defect. Formed flap sewn together, rolling its edges inside a suitcase handle on the skin defect under the tube impose tightening seams. Then after "training" (daily one end of the stalk to be cut off, pinch intestinal clip) cross the bridge and released his end is sewn into the defect or to a new location, closer to the defect. Migratory stalked flap can many times be transplanted from place to place, until he reaches of the defect. Cut a flap from the parent soil, just making sure it is securely engraftment in a new place.
After free skin grafting, and after dermepenthesis Filatov need a reliable fixation of the limbs and the body part where was the transplantation of skin flaps. The fixation is made with the help of the cast (splint), tyres. When soaking bandages serous or bloody discharge change only its surface layers. Remove all dressings earlier than expected (8-10 days after surgery) are produced at high temperatures, pus and other signs of infection wounds. When you remove the bandage on 8-10 days install engraftment of transplanted grafts of skin, removes dead areas, make toilet skin around the wound and put a bandage with indifferent ointments or oil (sterile liquid paraffin); ligation after 1-2 days.