Name of the Procedure:

Split-thickness Autograft, Trunk, Arms, Legs (Each additional 100 sq cm, or each additional 1% of body area of infants and children)

Summary

A split-thickness autograft involves taking a thin layer of skin from one part of the patient's body (donor site) to cover and heal a wound on another part (recipient site). This entry specifically refers to the use of such grafts for additional areas of 100 square centimeters or 1% of a child's body.

Purpose

This procedure is primarily used to treat extensive wounds that do not heal on their own, including burns, large abrasions, or areas impacted by surgical removal of tumors or infected tissue. The goal is to promote healing by covering the wound with healthy skin.

Indications

• Severe burns.
• Large, non-healing wounds.
• Surgical excision sites that cannot close naturally.
• Chronic ulcers or sores not responding to other treatments.
• Congenital or acquired skin defects.

Preparation

• Fasting may be required if general anesthesia is planned.
• Patients should avoid certain medications, such as blood thinners, before the procedure.
• Preoperative assessments, such as blood tests, and a thorough medical history undertaken to assess suitability for the procedure.

Procedure Description

1. Donor Site Preparation: The donor site, often the thigh, is cleaned and prepared.
2. Harvesting the Graft: A dermatome, a specialized tool, is used to remove a thin layer of skin from the donor site.
3. Recipient Site Preparation: The wound area is cleaned and prepared to receive the graft.
4. Placement of the Graft: The graft is carefully placed over the wound and secured with sutures or staples.
5. Dressings Applied: Both the donor and recipient sites are covered with dressings to protect them and promote healing.

Anesthesia: Either local anesthesia (numbing only the donor and recipient sites) or general anesthesia (patient is asleep) is used.

Duration

Typically takes between 1 to 2 hours, depending on the size of the area to be grafted.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeons specializing in plastic or reconstructive surgery.
• Anesthesiologist or nurse anesthetist.
• Surgical nurses and assistants.

Risks and Complications

• Infection at the donor or recipient sites.
• Graft failure (the graft may not fully take).
• Scarring at both donor and recipient sites.
• Bleeding or hematoma.
• Allergic reaction to anesthesia.

Benefits

• Promotes faster wound healing.
• Reduces risk of infection.
• Improves functional and aesthetic outcomes.
• Decreases pain associated with open wounds.

Recovery

• Dressings must be kept clean and dry.
• Follow-up appointments are necessary to monitor graft integration.
• Recovery time varies; full healing may take several weeks.
• Limited physical activity to avoid disturbing the graft.
• Pain management includes prescribed pain relievers and instructions on caring for the donor and graft sites.

Alternatives

• Comparative treatments might include full-thickness skin grafts or synthetic skin substitutes.
• Non-surgical options such as advanced wound care therapies may be suitable for less severe wounds.
• Each alternative has its own set of benefits, risks, and appropriateness based on the patient's condition.

Patient Experience

• On the day of the surgery, the patient will likely feel groggy from anesthesia.
• Pain and discomfort managed with medication.
• Initial redness, swelling, and minor pain at both the donor and recipient sites.
• Patients might experience itching or tightness as the graft heals.
• Clinical staff will provide ongoing support to maximize comfort and recovery outcomes.