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Anatomy of skin
 

 
Skin performs the important function of protecting the internal delicate  organs. When the two layers of the ruptured skin are brought together by proper stitches a healthy shelter to the underlying organs is provided and thus the body defenses come forward. So the point to keep in mind is, in any accident, the skin flaps must be protected in order to give a healthy cover to the underlying tissues and organs.
 
The wound must be stitched,  within six hours of the accident otherwise the doctor's work is increased and it becomes more expensive for the patient in terms of time, money and may be cosmetically too.
 
Plastic Surgery
  • When the skin is wrinkled, the extra part of the skin is surgically removed and the skin is stitched.  This is a simple plastic procedure and is termed as skin grafting.
     
  • Skin grafting either by free grafts or pedicled flap is necessary to obtain healing and to limit the deformity or disability when a large area has been lost by injury, (burns), disease (varicose ulcers) or by surgical excision of some carcinomas. Free skin grafts provide the simplest method of restoring the skin cover. But they can be used only when the raw surface is composed of healthy vascularised tissues or clean granulations.
     
  • The healing process is  prevented due to Ischaemia or infection.
     
  • Split thickness grafts are the ones most generally used. They have a tendency to shrink. They are usually taken from the thigh by means of a special knife.
     
  • The graft may be affixed by sutures or postage stamp sized flaps are applied, and the epithelium grows out from them to cover the intervening bare areas.
     
  • Appropriate  aseptic precautions are observed for both the grafted area and donor site (mostly the thigh).
     
  • Full thickness skin graft, without the fat content is more effective and gives better colour and texture than the split skin graft.
      
  • It does not show any tendency to contract and is more useful for the cosmetic areas like the face, but it needs more precautions to be taken and better care.
     

 

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