Surgery and Healing in the Developing World - Dartmouth-Hitchcock

26
246 Surgery and Healing in the Developing World
Figure 5. Split thickness skin graft from
anterior thigh taken with Humby manual
grafting knife over forehead donor area.
Bone grafts over the turn over flaps.
Figure 6. Postoperative appearance after forehead
flap is sutured.
Figure 7. Forehead flap. Lateral view at 3 weeks
when flap will be divided. Personality of patient has
changed.
bation can be completed with 1 mg per kg of suxamethonium. The average
adult dose is 50 mg. Valium at 5 to 10 mg I.V. will help with the emergence
phase. The drip can be stopped approximately 10 minutes before the end
of surgery.
3. The hairline is shaved back one inch and marked carefully. You do not wish
to transplant a hair-bearing region on the scalp or forehead to a hairless
portion of the face.
4. The most convenient location for the split thickness skin graft donor area is
the anterior thigh. The skin between the inguinal ligament and knee is
carefully prepped circumferentially. A very thin application of sterile mineral
oil is placed over the donor area as well as the instrument. The new
blade is positioned and the correct uniform thickness verified by vision and