Limb reconstruction

As a result of injury, surgery or disease it is sometimes necessary to replace tissue that is missing or has had to be removed surgically. This can be achieved with a variety of methods including split skin grafts, full thickness skin grafts, local, regional or free flaps.

Split skin grafts are usually harvested from the thigh or buttock. The graft can be applied to a wound to achieve healing. The area from which the graft has been taken (donor site) is like a deep graze. It heals with a simple dressing that stays in place for a period of a couple of weeks. It leaves a scar which usually fades with time.

Full thickness skin grafts can be removed from various areas of the body. The wound from which the skin is taken is then stitched with dissolving stitches. The skin can then be applied to the area where tissue was missing. It is held in place with a secure dressing for a week.

For defects in the hand, hairless skin is a preferable match and should ideally be harvested from a non hair bearing area of the body. In others circumstances for example eyebrow reconstruction, hair bearing skin is required and can be harvested from the scalp.

Flaps are thicker blocks of tissue that can be used to fill a nearby area of tissue loss or a distant area of tissue loss. The donor site (area from which the flap is taken) is either closed with stitches or it may require a skin graft. If the flap is completely detached from its origin, it can be secured to its new position with microsurgical techniques using an operating microscope.