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## Meet the editor

Dr. Madhuri Gore, a former Professor and Chief of Surgery at Lokmanya Tilak Municipal Medical College and General Hospital (LTMGH), India, is presently a consultant general surgeon in Mumbai, India. Her areas of interest are burns, non-burn trauma and wounds, and venous diseases. An acknowledged teacher and sought-after speaker, Dr. Gore established the first cadaver skin bank in India. She is an avid researcher and has been the chief

investigator for more than twenty-five national and international clinical trials. She has more than seventy-five publications in national and international journals to her credit and has contributed seventeen chapters to various books. She has been honored with several awards, prizes, scholarships, and orations for her contribution to the fields of her special interest.

Contents

**Section 1**

*by Rahul Gorka*

*by Madhuri Gore*

**Section 2**

Types of Skin Grafts *by Verónica Olvera-Cortés*

in Complex Wounds

in Promoting Wound Healing

Skin Graft Fixation and Methods

*Florencia Disi and Juan Olivares*

Preparation for a Successful Skin Grafting

*by Ahmad Farouk Musa and Cheang Jia Min*

**Preface XI**

Wound Bed Preparation **1**

**Chapter 1 3**

**Chapter 2 13**

**Chapter 3 29**

Skin Grafting **55**

**Chapter 4 57**

**Chapter 5 69**

**Chapter 6 81**

Experience of Wound Bed Preparation with Different Methods

*Haruan* Extract (*Channa striatus*) as an Effective Mediator

*by Sundaram Ravanasamudram Rajaram and Gauthami Sundar*

Procurement and Use of Cryopreserved Total Skin Allograft

*by Marcelo Fonseca, Aldo Cañete, Dino Ibaceta, Catalina Buchroithner,* 

### Contents


Preface

Wounds are common injuries that almost every human being experiences. They can vary in depth of tissue damage, etiology, location, contamination, lymphovascular integrity, and sensory neural function. They can be associated with diabetes, cardiovascular morbidity, hepatic and/or renal dysfunction, immunological status, malignancy, nutritional deficiencies, and so on. Wound healing is dependent on all these factors and

Wounds that are limited to the epidermis and superficial layers of the dermis generally close and heal naturally. We now know the stages in this process and understand the role of multiple mediators, growth factors, cellular contributions, and the interaction between these components. However, there is no method by which we can control or

The situation is different when the wound involves full-thickness skin loss with or without loss of subcutaneous and deeper tissue. These wounds cannot achieve closure naturally, as both epidermal and dermal elements are lost. Without intervention, these wounds may remain as chronic, non-healing ulcers or they may close via wound contraction and formation of scar tissue causing functional limitations, deformities, and disfigurement. These scars may be unstable, leading to repeated breakdown, and are likely to develop Marjolin's ulcer, which is most often a squamous cell carcinoma of aggressive nature. Hence, a general recommendation is that wounds that do not close or that are not likely to close within 3–4 weeks of occurrence should be closed surgically

This book, *Skin Grafts for Successful Wound Closure*, focuses on various aspects related to free skin grafts; it does not address flaps. Skin autografts are necessary for providing permanent wound closure. While harvesting a split-thickness skin autograft from the appropriate donor area on the body of the patient, the surgeon is creating a partialthickness wound that needs care for healing. Justifying this new wound and the pain and scarring associated with its healing requires a successful skin graft. Optimal preparation

Section I, "Wound Bed Preparation," includes three chapters that elaborate on the different methods of wound bed preparation. The simultaneous management of systemic factors is necessary but is not within the purview of this publication.

The knowledge and practice of wound care are mandatory for all surgeons and thus every surgical trainee should know the basics as well as keep up with advances in the field of wound bed preparation and skin grafting procedures. As such, Chapter 1, "Preparation for a Successful Skin Grafting," in Section I describes various established methods for wound bed preparation. Although relatively new, negative pressure wound therapy is already well accepted and its efficacy has been illustrated in photographs. However, there is always a search for newer, better, easily available, and affordable topical agents, dressing materials, and techniques. Everything new requires evaluation and established methods need to be revalidated. Chapter 2, "Experience of Wound Bed Preparation with Different Methods," describes the experience of the author in evaluating a new topical agent and foam dressing prepared using new technology. It also describes the experience of using skin allografts and xenografts in a setting where

many more.

modify this natural process of wound healing.

with skin grafting or fasciocutaneous or myocutaneous flaps.

of the recipient wound bed is essential for the success of the graft take.
