Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Reconstructive Surgery in the Tropics
Figure 8. Forehead flap. Five weeks after surgery.
Figure 9. Forehead flap. Six and one half years later.
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palpation. With an assistant supporting the thigh and assuring a maximal
skin surface presentation to the skin grafting knife, the instrument is brought
up the thigh from knee to groin with a smooth back and forth movement.
The split thickness skin graft is covered with normal saline soaked sponges.
Floating the grafts in normal saline is thought to remove some important
components of the graft. When the area for grafting is ready, the skin grafts
are laid out atraumatically. Circumferential sutures are placed for stabilization.
Small openings in the split thickness graft are made prior to application.
The skin graft is placed against a sterile wood block while multiple
small incisions are made across its surface with a sharp knife.
5. A dressing is placed over the anterior thigh donor site. Use a nonstick vaseline
gauze covered with dry sterile gauze and a wrap around bandage for the
donor site. The outer nonvaseline dressing is removed at 5 days.
6. An incision is made over the iliac crest from the anterior superior iliac spine
laterally for 8 cm. The periosteum is elevated on the superior and inferior
surface of the iliac wing. Using a sharp chisel a 6 cm and 3 cm segment of
bone is removed.
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