Skin Flap Alternative - Complex Linear Wound Closure | Optimal Wound Closure
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Archive by category: Skin Flap AlternativeReturn
"When I want to eliminate patient post-op visits for suture removal, I have been using the HEMIGARD device with the retention suture, followed by deeps and top fast gut sutures." Stephanie Howerter, DO, FACMS
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We have previously discussed skin grafts and flaps (link to those posts). The major distinction in a skin flap and skin graft is blood supply. Skin flaps have a connected blood supply. Skin grafts do not have connected blood supply. Recall that the lack of a connected blood supply limits the potential thickness of a skin graft. If the graft is too thick, the blood supply from the wound base may be inadequate and result in partial or total loss of the graft.
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You may recall that a skin graft involves taking a piece of skin from one area of the body and using that skin to cover the original wound (link to blog post Oct 4). The graft relies on the blood supply of the wound bed to get nutrition. During the first few days after the grafted skin is placed, the graft will “drink” from the wound bed, hence the term imbibition. By day 3 to 5, the graft has usually created adhesions to the wound bed.
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By: Dan Ladizinsky, MD, CEO, SUTUREGARD Medical, Retired Board Certification in General Surgery, Plastic Surgery, with Certificate of Added Qualifications in Surgery of the Hand, Former Fellow of the American College of Surgeons. Undermining is a surgical technique that mechanically separates the skin & superficial subcutaneous fat as one layer, away from its underlying soft tissues. Undermining can be done in a superficial or deep subcutaneous plane if you want to learn more about why not to us...
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