Split Thickness Skin Graft

DVT prophylaxis has been ordered within 24hrs of surgery

Second generation cephalosporin / therapeutic antibiotics were started prior to incision.

The patient was correctly identified and brought to the operating room. General anesthesia was administered. The patient was positioned supine on the operating room table. His leg was prepped and draped in sterile fashion. His thigh was prepped out for harvest of skin graft. A time out procedure was performed.

We began by marking out the area of skin graft harvest site to correspond with the area of coverage needed for the wound. We used mineral oil lubrication of the thigh harvest site. The skin was then harvested using a Zimmer Dermatome set to 0.006 to 0.015 in (usually 0.010 in). The graft was placed with dermal side up on a 1:1.5 mesh board and meshed.

The harvest site was packed with epi soaked gauze (1mg of 1:1000 (1mg/ml) epi in 500ml saline) .

We then prepped the wound with irrigation and light curetting. The wound surface was clean. The graft was placed into the wound bed with dermal side down and tacked in place with staples. We then applied Adaptec with Vaseline followed by black sponge VAC.

Hemostasis was ensured at the harvest site. We then dressed the wound with xeroform stapled to the wound followed by pie crusted Tegaderm and ABDs.

The patient tolerated the procedure and is transferred to recovery.

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