free skin graft

WordNet

1. unconstrained or not chemically bound in a molecule or not fixed and capable of relatively unrestricted motion; "free expansion"; "free oxygen"; "a free electron"
2. people who are free; "the home of the free and the brave" (同)free people
3. free from obligations or duties (同)discharge
4. free or remove obstruction from; "free a path across the cluttered floor" (同)disengage
5. grant freedom to; free from confinement (同)liberate, release, unloose, unloosen, loose
6. not literal; "a loose interpretation of what she had been told"; "a free translation of the poem" (同)loose, liberal
7. make (information) available for publication; "release the list with the names of the prisoners" (同)release
8. able to act at will; not hampered; not under compulsion or restraint; "free enterprise"; "a free port"; "a free country"; "I have an hour free"; "free will"; "free of racism"; "feel free to stay as long as you wish"; "a free choice"
9. not held in servitude; "after the Civil War he was a free man"
10. not occupied or in use; "a free locker"; "a free lane"
11. bruise, cut, or injure the skin or the surface of; "The boy skinned his knee when he fell" (同)scrape
12. a persons skin regarded as their life; "he tried to save his skin"
13. a bag serving as a container for liquids; it is made from the hide of an animal
14. an outer surface (usually thin); "the skin of an airplane"
15. a natural protective body covering and site of the sense of touch; "your skin is the largest organ of your body" (同)tegument, cutis
16. strip the skin off; "pare apples" (同)peel, pare
17. cause to grow together parts from different plants; "graft the cherry tree branch onto the plum tree" (同)engraft, ingraft
18. the act of grafting something onto something else (同)grafting
19. (surgery) tissue or organ transplanted from a donor to a recipient; in some cases the patient can be both donor and recipient (同)transplant
20. move along on skis; "We love to ski the Rockies"; "My children dont ski"
21. narrow wood or metal or plastic runners used in pairs for gliding over snow
22. a sport in which participants must travel on skis

PrepTutorEJDIC

1. (束縛された状態になく)『自由な』,自由の身の / (国家・国民などが)『独立している』 / (思想・行為などが)強制されない,自発的な / (動作が)拘束されない,無理のない / 《補語にのみ用いて》(苦痛・制約などを)『免れている』,(誤り・偏見などの)ない《+『from』(『of』)+『名』》 / 《補語にのみ用いて》《『be free to』do》『自由に』…『できる』 / (仕事から)解放された,暇になった;(部屋などが)使用されていない,空いた / 『無料の』;無税の / 出し惜しみしない / 遠慮のない,慎みがない / (道路などが)障害のない,自由に通れる / 固定していない,離れた / 無料で / 自由に,妨げられずに(freely) / (…から)〈人・国など〉‘を'『自由にする』,解放する《+『名』+『from』+『名』》 / (困難などから)〈人〉‘を'救う《+『名』+『form』+『名』》 / (障害などを)〈人・物〉‘から'取り除く《+『名』+『of』(『from』)+『名』》 / (物を)…‘から'片付ける,外す《+『名』+『of』+『名』》
2. 〈U〉〈C〉(人・動物の)『皮膚』,肌 / 〈C〉〈U〉(動物からはいだ)『皮』,『毛皮』;皮製品,皮袋 / 〈C〉(果物・野菜の)皮 / 〈U〉〈C〉(液体の表面にできる)薄い膜,上皮 / 〈C〉(枠組み・表面などを覆う)外皮,外被,外板 / 〈動物・果物など〉‘の'皮をはぐ(むく) / 〈手・脚など〉‘を'擦りむく / 《話》(金などを)〈人〉‘から'巻き上げる《+『名』〈人〉+『of』+『名』》 / 〈傷口などが〉皮で覆われる《+『over』》
3. (つぎ木の)つぎ穂;つぎ木 / (皮被・内臓・骨などの)移植片 / (木に)〈つぎ穂〉‘を'つぐ,(体に)〈移植片〉‘を'移植する《+『名』+『on』(『upon』,『in』,『into』)+『名』》 / …‘を'結合させる《+『名』+『together』》 / (…に)つぎ木する,移植する《+『on』(『upon』,『in』,『into』)+『名』》
4. 収賄,汚職;贈賄;〈C〉汚職で得たもの / 汚職する,収賄する
5. 『スキー』 / 『スキーで滑走する』 / …‘を'スキーで滑る / スキーの,スキー用の
6. (スポーツとしての)『スキー』;スキー術

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/03/10 16:10:31」(JST)

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[Wiki en表示]

Skin grafting
Intervention
Skin graft on lower leg trauma injury, 5 days after surgery healing aided by use of a vacuum dressing
ICD-9-CM	86.6
MedlinePlus	002982

Skin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft.

Skin grafting is often used to treat:

• Extensive wounding or trauma
• Burns
• Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans
• Specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers

Skin grafts are often employed after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reduce the course of treatment needed (and time in the hospital), and improve the function and appearance of the area of the body which receives the skin graft.

There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section) like peeling a potato, or a full thickness skin graft, which involves pitching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar. For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft.

Medical uses

Two layers of skin created from animal sources has been found to be useful in venous leg ulcers.

Graft taxonomy

• Autologous: The donor skin is taken from a different site on the same individual's body (also known as an autograft).
• Isogeneic: The donor and recipient individuals are genetically identical (e.g., monozygotic twins, animals of a single inbred strain; isograft or syngraft).
• Allogeneic: The donor and recipient are of the same species (human→human, dog→dog; allograft).
• Xenogeneic: The donor and recipient are of different species (e.g., bovine cartilage; xenograft or heterograft).
• Prosthetic: Lost tissue is replaced with synthetic materials such as metal, plastic, or ceramic (prosthetic implants).

Graft classification

Skin grafts can be:

Split-thickness

A split-thickness skin graft (STSG) is a skin graft including the epidermis and part of the dermis. Its thickness depends on the donor site and the needs of the patient. It can be processed through a skin mesher which makes apertures onto the graft, allowing it to expand up to nine times its size. Split-thickness grafts are frequently used as they can cover large areas and the rate of autorejection is low. The same site can be harvested again after six weeks. The donor site heals by re-epithelialisation from the dermis and surrounding skin and requires dressings.

Full-thickness

A full-thickness skin graft consists of the epidermis and the entire thickness of the dermis. The donor site is either sutured closed directly or covered by a split-thickness skin graft.

Composite graft

A composite graft is a small graft containing skin and underlying cartilage or other tissue. Donor sites include, for example, ear skin and cartilage to reconstruct nasal alar rim defects.

Donor selection

When grafts are taken from other animals, they are known as heterografts or xenografts. By definition, they are temporary biologic dressings which the body will reject within days to a few weeks. They are useful in reducing the bacterial concentration of an open wound, as well as reducing fluid loss.

For more extensive tissue loss, a full-thickness skin graft, which includes the entire thickness of the skin, may be necessary. This is often performed for defects of the face and hand where contraction of the graft should be minimized. The general rule is that the thicker the graft, the less the contraction and deformity.

Cell cultured epithelial autograft (CEA) procedures take skin cells from the patient to grow new skin cells in sheets in a laboratory. The new sheets are used as grafts, and because the original skin cells came from the patient, the body does not reject them. Because these grafts are very thin (only a few cell layers thick) they do not stand up to trauma, and the "take" is often less than 100%. Newer grafting procedures combine CEA with a dermal matrix for more support.Research is investigating the possibilities of combining CEA and a dermal matrix in one product.

Experimental procedures are being tested for burn victims using stem cells in solution which are applied to the burned area using a skin cell gun. Recent advances have been successful in applying the cells without damage.

Split skin graft donor site 8 days after the skin was taken

In order to remove the thin and well preserved skin slices and strips from the donor, surgeons use a special surgical instrument called a dermatome. This usually produces a split-thickness skin graft, which contains the epidermis with only a portion of the dermis. The dermis left behind at the donor site contains hair follicles and sebaceous glands, both of which contain epidermal cells which gradually proliferate out to form a new layer of epidermis. The donor site may be extremely painful and vulnerable to infection.

The graft is carefully spread on the bare area to be covered. It is held in place by a few small stitches or surgical staples. The graft is initially nourished by a process called plasmatic imbibition in which the graft "drinks plasma". New blood vessels begin growing from the recipient area into the transplanted skin within 36 hours in a process called capillary inosculation. To prevent the accumulation of fluid under the graft which can prevent its attachment and revascularization, the graft is frequently meshed by making lengthwise rows of short, interrupted cuts, each a few millimeters long, with each row offset by half a cut length like bricks in a wall. In addition to allowing for drainage, this allows the graft to both stretch and cover a larger area as well as to more closely approximate the contours of the recipient area. However, it results in a rather pebbled appearance upon healing that may ultimately look less aesthetically pleasing.

An increasingly common aid to both pre-operative wound maintenance and post-operative graft healing is the use of negative pressure wound therapy (NPWT). This system works by placing a section of foam cut to size over the wound, then laying a perforated tube onto the foam. The arrangement is then secured with bandages. A vacuum unit then creates negative pressure, sealing the edges of the wound to the foam, and drawing out excess blood and fluids. This process typically helps to maintain cleanliness in the graft site, promotes the development of new blood vessels, and increases the chances of the graft successfully taking. NPWT can also be used between debridement and graft operations to assist an infected wound in remaining clean for a period of time before new skin is applied. Skin grafting can also be seen as a skin transplant

Risks

Risks for the skin graft surgery are:

• Bleeding
• Infection
• Loss of grafted skin
• Nerve damage
• Graft-versus-host disease

Rejection may occur in xenografts. To prevent this, the patient usually must be treated with long-term immunosuppressant drugs.

Prognosis

Most skin grafts are successful, but in some cases grafts do not heal well and may require repeat grafting. The graft should also be monitored for good circulation.

Recovery time from skin grafting can be long. Patients should wear compression garments for several months and be monitored for depression and anxiety consequent to long-term pain and loss of function.

History

First skin grafting was performed in India in 1st century.

References

External links

• Skin graft. MedlinePlus Medical Encyclopedia. Parts of this US Federal Government public domain text were used in the article.
• An introduction to the use of vacuum assisted closure.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

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• 4. 再建術のためのグラフトおよび弁の原理 principles of grafts and flaps for reconstructive surgery
• 5. 手熱傷の一次外科的マネージメント primary operative management of hand burns

English Journal

• Cervicothoracic reconstruction with an anteromedial thigh flap: A novel flap concept.

• Leduey A, Leymarie N, Bidault F, Fadel E, Dartevelle P, Kolb F.SourceInstitut Gustave Roussy, Department of Plastic Surgery, 114 rue Edouard Vaillant, 94805 Villejuif, France. Electronic address: Alexandre.leduey@igr.fr.
• Journal of plastic, reconstructive & aesthetic surgery : JPRAS.J Plast Reconstr Aesthet Surg.2013 Jun;66(6):855-8. doi: 10.1016/j.bjps.2012.09.038. Epub 2012 Nov 17.
• The anteromedial thigh region is more popular as a donor site for skin graft than for flap. It is an extended area whose limits are poorly defined. This explains why flaps vascularised by different source arteries but described under the same name can be found in the literature introducing confusion
• PMID 23168095

• Hair Transplantation on a Free Microvascular Latissimus Dorsi Flap: Case Report.

• Veir Z, Kisić H, Mijatović D, Bogdanić B, Duduković M, Kunjko K, Veir H, Zadro Z.SourceFrom the *Departments of Plastic Surgery and †Surgery, University Hospital Center Zagreb, Zagreb; and ‡Department of Surgery, General Hospital Karlovac, Karlovac, Croatia.
• Annals of plastic surgery.Ann Plast Surg.2013 May 15. [Epub ahead of print]
• Large scalp defects can present as a challenging clinical problem for a reconstructive surgeon. We present a patient with a large scalp defect following an infection after neurosurgical treatment. Reconstruction of a defect was performed using a free latissimus dorsi flap with split-thickness skin g
• PMID 23676522

Japanese Journal

• 手部挫滅による皮膚欠損と骨軟骨欠損に対し遊離上腕外側皮弁と有頭骨軟骨移植術を用いて同時再建した 1 例

• 日本マイクロサージャリー学会会誌 29(2), 114-119, 2016
• NAID 130005158580

• 爪を含めた足趾からの組織移植による指尖部再建の成績と問題点

• 日本マイクロサージャリー学会会誌 28(4), 166-170, 2015
• NAID 130005116244

• 血液透析患者に生じた膝の難治性潰瘍に対して遊離広背筋皮弁移植を行って患肢救済ができた1例

• 日本マイクロサージャリー学会会誌 28(4), 212-215, 2015
• NAID 130005116242

Related Links

• Free graft | definition of free graft by Medical dictionary

graft [graft] 1. any tissue or organ for implantation or transplantation. 2. to implant or transplant such tissues. This term is preferred over transplant in the case of skin grafts. See also implant. allogeneic graft allograft. autodermic graft (autoepidermic graft ...

• Skin graft: MedlinePlus Medical Encyclopedia

This surgery is usually done while you are under general anesthesia. That means you will be asleep and pain-free. Healthy skin is taken from a place on your body called the donor site. Most people who are having a skin ...

Related Pictures

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★リンクテーブル★

リンク元	「遊離植皮」
関連記事	「free」「graft」「grafting」「skin」

「遊離植皮」

　　[★]

英

free skin graft

同

free grafting

関

(術式名)遊離植皮術、植皮術

• 移植片から血管を切断して行う植皮術で、血行が一時、完全に遮断される。　⇔　有茎植皮術

「free」

　　[★]

• adj.

• 遊離の、遊離型の、自由な、無料の、フリーの、取り除く、(接尾辞的に用いて;～を)含まない

関

ad lib、ad libitum、deprive、disengage、free form、free of charge、freedom、freely、liberate、liberation、obviate、omit、release、remove、strip、withdraw

　 　 　 　 　 　 　 　 　 　 　

「graft」

　　[★]

• n

• 移植片、グラフト

• v.

• 移植する、(植物)接木する

関

cell transplant、engraft、engraftment、explant、grafting、implant、implantation、organ graft、organ transplant、tissue graft、tissue transplant、transfer、transplant、transplant recipient、transplantation

　 　 　 　 　

「grafting」

　　[★]

• n.

• 移植、移植法、移植術

関

engraft、engraftment、graft、implant、implantation、transfer、transplant、transplantation

「skin」

　　[★]

• n.

• 皮膚