Skin Grafts & Flaps
Dr Tew uses her knowledge and refined skills to aid with the following procedures:
Split Skin grafts
Traumatic wounds can occur as the result of accidental falls, motor vehicle collisions and more. Skin grafting has developed throughout the years, from small grafting techniques, Dermatome or skin-depth grafting and Mesher grafting - which is a technique using perforations in the donor skin to allow it to stretch to its new site and position.
For a skin graft to “take” means picking up blood supply from the recipient site. Successful grafts require adequate blood flow at the new site, a prevention of clotting and an absence of infection over time - antibiotics are often administered for the latter.
Immobilisation with a plaster or splint or negative pressure devices prevent the accumulation of blood or serous fluid that would hinder “take”.
We also need to give the graft time to grow and absorb its new blood supply, which is normally about 1 week, with the graft remaining in a delicate state for 3 weeks.
Full Thickness Skin Grafts
Dr Tew is capable of harvesting full thickness skin grafts from donor sites that can be closed for healing afterwards. Examples are the lower abdomen, the lower neck, behind the ear, and the inner arm.
The result is a graft that is thicker and of better colour match to the recipient site, for instance, using skin from around the ear to match the nose.
This technique is more widely used in reconstruction for skin cancer where the recipient defect is small, and the colour match for the face is important.
Local Flap Reconstruction
In the search for better tonal match of skin. Skin flaps close to the original defective site can also be moved in order to get an ideal result. For instance, to reconstruct the nose, the surgeon can use skin from the nasolabial fold.
Distant Flap Reconstruction
For more complex wounds, there are skin flaps that can be transported from distant sites, and carry their own blood supply.
For instance, the groin skin flap can be used to reconstruct defects in other areas of the body. For the thumb, it could be a pedicle-type flap. For the leg defect, microsurgery would be required.
Recovery in hospital for skin grafts takes about 10 days, followed by several weeks of dressing the wound.