plastics overview, burns, grafts

what sutures are typically used size and name

2-0 to 9-0 nylon, vicryl, ticron, PDS

why should you never use epinephrine on fingers or toes

can cause necrosis

cutting instruments are designed to remove split thickness graft

dermatome

uses straight edge razor blade mounted on a handle, “free hand” technique, for small grafts

ferris smith knife-dermatome

same as ferris smith, but has 3 interchangeable guards, can also be used for burn wound debridement

weck knife-dermatome

blade heads come sterile, disposable, handle is placed into sterile bag, battery operated

duval

semicircular-measures 4×8 in., adjustable blade, adjustable handle to control depth

padgett hood

shims are placed to control depth

reese

ultraviolet light used to determine viability of tissue/flaps, 20cc of 5% sodium fluorescein IV, room darkened, viable tissue will glow

woods lamp

used for liposuction, need sterile tubing and various sized and angled cannulas

suction lipectomy machine

powered handpiece designed to mechanically even the layers of dermal tissue, abrasive discs, burs, wire brushes, sanding attachment

dermabrader

xomed, nerve integrity monitor, used for neck, hand, craniofacial surgeries

nerve stimulator

uses a subcutaneous implanted balloon and valve device into which saline is injected, used when a greater amount of skin is needed for grafting

tissue expanders

involves only outside layer of epidermis, symptoms include redness, heals in a few days

1st degree burn

injury to the epidermis & portion of dermis, symptoms include pain, blister, scar formation, epithelium regenerates

2nd degree burn

destruction of entire skin thickness extending into subq. and/or further, symptoms include dry, white skin with minimal pain, develops thick, leathery crust called eschar(necrotic tissue), no possibility of epithelium regeneration

3rd degree burn

section of skin is freed and transplanted to an area of skin that has been denuded

skin graft

replace areas of lost fascia or collagen

fascia lata

sterile membrane prepared from the peritoneum of an ox; used in abdominal surgery to interpose between surfaces to prevent the formation of adhesions

cargile membrane

used for AV fistulas, interposition graft between the subclavian artery and pulmonary artery, peripheral bypass graft surgery vascular bypass

human umbilical cord vein graft

used when dura is too damaged or tear is too large to be sewn together

human dura mater

harvested bone is processed and stored for future use

bone bank

replaces missing bone in order to repair bone fractures that are extremely complex or fail to heal properly

bone grafts

tissue graft or organ transplant from a donor of a different species from the recipient

xenograft

dermis from a pig

porcine dermis

deep inner layer of the skin, beneath the epidermis, containing connective tissue, blood vessels, adn fat

corium

patients own skin/tissue

autograft

skin/tissue from another human

allograft

graft that contains epidermis and small portion of dermis, varies from thin to thick, thigh and abdomen most common site, only skin graft that uses dermatome

split thickness graft

graft used for surgical reconstruction, skin graft that is composed of other types of tissues: adipose, cartilagem mucous membrane. limited to use in highly vascular areas; scalp, nipple area, nose, ears

composite graft

graft that contains epidermis, dermis, and sometimes subq. used where graft will experience pressure and wear; hands, elbows, feet, neck. Retains a more normal appearance

full thickness graft