Composition of bone and apatitic biomaterials as revealed by intravital Raman microspectroscopy

SKIN GRAFTING: From Here to There

Free skin grafts for soft tissue reconstruction can be classified into three types: full-thickness skin grafts, split-thickness skin grafts, and composite grafts. The indications, techniques, donor site considerations, and postoperative complications of each type of skin graft are reviewed.

https://www.jaad.org/article/0190-9622(92)70164-B/pdf

Soft tissue reconstruction with skin grafting.

The Pathogenesis of Hypertensive Encephalopathy

Background

Lymphoedema is a common complication of breast cancer treatment, affecting approximately a quarter of patients. Those affected can have an uncomfortable, unsightly and sometimes functionally impaired limb prone to episodes of superficial infection. The aetiology, pathophysiology and management of these patients is poorly understood.



Methods

This is a systematic review of all published literature on lymphoedema following treatment for breast cancer, using the Medline and Cinahl databases with cross-referencing of major articles on the subject up to the end of 1999.



Results and Conclusion

The aetiology and pathophysiology of lymphoedema in patients with breast cancer appear to be multifactorial and are still not fully understood. Although conservative treatment techniques can be very successful in controlling symptoms, they do not afford a cure. The place of surgical and pharmacological therapy remains unclear. Improved understanding of the pathophysiology may assist in reducing the incidence of this condition, or help to identify those at greatest risk, in whom early initiation of conservative treatment measures may prove effective. © 2000 British Journal of Surgery Society Ltd

Lymphoedema following surgery for breast cancer.

In a full-thickness scrotal autograft transplanted to a rabbit's ear inside a transparent ear chamber, the following events were observed through a high resolution vital microscope: 1. To and fro circulation of plasma and red blood cells around the graft and sometimes of donor area blood contained within the preexisting vessels of the graft begins immediately after the graft is laid in place. 2. Slow irregular circulation of blood from the recipient bed begins in the graft, 24 to 48 hours after grafting. 3. Circulation first develops inside the preexisting vessels of the graft. 4. Moderate vascular proliferation starts shortly after circulation begins. In this study, it appeared to originate from preexisting graft vessels. 5. Modification of the preexisting vascular pattern of the graft takes place after circulation begins. It is presumably due to the new blood flow characteristics which depend largely on the circulation in the recipient bed and on the recipient bed to graft connections. 6. Graft epiderma...

The vascularization of a free full thickness skin graft. I. A vital microscopic study.

In contact microangiograms of full-thickness scrotal autografts transplanted to the ears of rabbits, the following events were noted: 1. The first vascular filling within the graft was noted between 24 and 48 hours after grafting. It was characterized by poor vascular filling with contrast medium which suggested irregular blood circulation and perhaps a low perfusion pressure. 2. The first vascular connections between recipient bed and graft were few. They were between the recipient bed and the mouths of large dilated vessels in the graft. 3. Invasion of the lower layers of the graft by capillaries from the recipient bed was noted between 48 and 72 hours after grafting. This invasion did not seem to be responsible for the increased number of small vessels in the superficial layers of the graft. New vessels in the superficial layers of the graft appeared to arise from preexisting graft vessels. 4. Vascular dilatation in the recipient bed and graft were marked until about the second or third day after graft...

The vascularization of a free full thickness skin graft. II. A microangiographic study.

A full-thickness scrotal skin autograft transplanted to an ear of a rabbit shows the following heat emission changes when studied with infrared thermography under the conditions of this experiment:1. Normal heat emission from recipient bed vessels under the graft is present immediately after grafting, but is soon masked by graft edema. The normal pattern of heat emissions from the recipient bed is restored by the sixth to eighth day after grafting when edema has disappeared.2. Recipient bed vasodilatation and proliferation slightly increases the heat emission from the graft area if this area is not masked by graft edema.3. Areas with or without a fibrinous scab, but uncovered by epithelium are registered thermographically as slightly colder than the surrounding normal skin. This appears to be the result of evaporation from their surfaces.

The Vascularization of a Free Full Thickness Skin Graft:III. An Infrared Thermographic Study

An investigation of rabbit ear burns studied by macrophotography, infrared thermography and microangiography has revealed that (1) infrared thermography is an accurate method of evaluating the severity of a burn and of prognosticating the fate of the burned tissue, (2) patency of the vascular supply to the skin appears to be the deciding factor in whether a deep partial-thickness burn eventually heals or becomes an area of full-thick-ness skin loss. These findings emphasize the need for further investigations into the effects of burning on the skin vasculature and for further efforts directed toward maintaining circulation in these burned vessels.

J. Birch

Papers

The vascularization of a free full thickness skin graft. I. A vital microscopic study.

The vascularization of a free full thickness skin graft. II. A microangiographic study.

The Vascularization of a Free Full Thickness Skin Graft:III. An Infrared Thermographic Study

Vascular reactions in an experimental burn studied with infrared thermography and microangiography.

Vascular reactions in an experimental burn studied with infrared thermography and microangiography