Taking Epidermophyton flap

Epidermoidnyi flap consists of epidermis and valonsadero layer of the skin. Its thickness in cattle 0.8 to-2.7 mm that is 1/4-1/3 of the entire thickness of the skin; the horse of 0.8 - 2.7 mm or 1/2-1/4 of the thickness of the skin; in sheep and dogs to 0.9 - 2.7 mm or 1/2-2/3 of the thickness of the skin. This variation is related to the difference in the structure of the skin on the body with age and breed characteristics, as well as with the seasonal changes of the skin. When properly capture polyarnogo flap off line passes on 200-300 microns deeper occurrence of hair bulbs (Fig. 4). Epidermoidnyi flap can be obtained in two ways: by splitting pre dissected full-thickness flap and by direct its cutting at the donor site using a dermatome.
Making epidermoidnyi the transplant by splitting full-thickness flap, knife or the razor excised the needed value of the flap with the seizure of all skin layers. Deformed flap fix subcutaneous tissue out on a cylindrical surface (bent thick rubber, plywood or bottles), by pre-wrapped with several layers of gauze. Then with a razor or the carefully crafted scalpel cut subcutaneous and part mesh layer. With proper cutting these layers formed surface Epidermophyton layer has a grayish tint and when viewed edge flap or cuts made at its center, visible undamaged roots of hair, and underneath the thin strip mesh layer. The appearance of the cut surface is dark dots cut hair indicates a bad splitting of the flap.


Fig. 5. Burn (2% of III degree) left chest wall horses: 1 - transplanted into the thickness of granulation tissue small pieces of skin; 2 - wound at the crime scene transplant closed deaf seam.

The wound surface, formed at the donor site, must be closed, or by imposing a deaf seam, or by plastics - by shifting the surrounding skin (Fig. 5).
During the capture of the flap dermatome, you must first set the thickness of cut transplant, i.e. to determine the depth of the donor area of skin hair bags.
I. I. Shneiberg recommends the following method to determine the depth of the hair follicles. At the donor site of the skin, without subcutaneous tissue, gather in the surface fold and measure it. Half value measurement is the thickness of the skin. From this and expect the depth of the hair follicles. To the measure of the depth of the hair follicles add 200-300 microns. Obtained indicator of the depth of cut establish on microcellulaire dermatome and excised the transplant. When taking transplant formed the cut surface of the donor area has a whitish appearance; bleeding, usually drip and in rare cases, a small trickle. When viewed from the edge of the dissected flap visible roots of hair, and underneath the thin white strip of dense connective tissue mesh layer.
On taken the flap staggered make incisions in length 0,3-0,5 mm
I. I. Shneiberg recommends that you do on the flap through multiple injections, 4-5 injections on each square inch of surface and on every 10-15 cm2 single incision length 4-5 mm pinned transplant on the wound surface through these holes remove the residues of air, blood and provide the flow of wound exudatethat prevents delamination transplanted graft.
Epidermoidnyi rags well acclimatized and create sustainable elastic growing coat the skin.
The disadvantage transplant epidermoidnyi patch is that generated by their taking the defect is very rare heals by epidermization from the edges of the wound. Generally remaining in the defect part of the net layer of skin will prevent rapid healing. In these cases it is recommended to excise with a scalpel remaining part of the net layer to the subcutaneous tissue and close the wound by sliding the surrounding skin with the imposition of a seam.