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• Important source of
epithelial cells,
Neutrophils (appear at H6- Clearance of invading microbes and cellular debris in the wound
last usually a few days) area
Macrophages (appear D3- (Early) Release cytokines that promote the in ammatory
D5) response by recruiting and activating additional leukocytes
• Fibroplasia
• Cell proliferation
• Starts D3-D4
Tissue proliferation
Remodeling
• Epithelialisation provides a
watertight seal within 48 hours.
• 20% by 2 weeks
• 40% by 3 weeks
• High-dose UV lessen
scars in rabbit ear model !
Meaume S et al. Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol 2014; 24(4): 435-43
Welshhans JL et al. Soft Tissue Principles to Minimize Scarring. An Overview. Facial Plast Surg Clin N Am 25 (2017) 1–13
LIMITING FACTORS
Local factors Systemic factors
Oxygenation Age (old) and gender (male)
Venous insuf ciency Diminished wound vascularisation (diabetics, cardiac insuf ciency, irradiation,…)
(favors edema)
Obesity (hypoperfusion of adipose tissue- increased tendon on the wound)
• Clean wound
• Well vascularized
mesenchymatous interactions.
• Immune compatibility
• Neoangiogenesis
• Adherence
• Immobilization of the
graft is mandatory.
TAKING OF SKIN GRAFTS
• Tissues able to produce granulation tissue
(subcutis, muscle, periosteum, and
perichondrium).
• Tissue nourishment is
maintained by the exudate.
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TAKING OF SKIN GRAFTS
• Inosculation = Revascularization phase (5-7 days) ≈
broplasia,
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