Graft (surgery)
| Graft (surgery) | |
|---|---|
| MeSH | D019737 |
Graftingrefers to asurgical procedureto movetissuefrom one site to another on the body, or from another creature, without bringing its ownblood supplywith it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact is called aflap.In some instances, a graft can be an artificially manufactured device. Examples of this are a tube to carry blood flow across a defect or from anarteryto aveinfor use inhemodialysis.
Classification
[edit]Autografts and isografts are usually not considered asforeignand, therefore, do not elicitrejection.Allografts and xenografts may be recognized as foreign by the recipient and rejected.[1]
- Autograft:graft taken from one part of the body of an individual and transplanted onto another site in the same individual, e.g., skin graft.
- Isograft:graft taken from one individual and placed on another individual of the same genetic constitution, e.g., grafts betweenidentical twins.
- Allograft:graft taken from one individual placed on a genetically non-identical member of the same species.
- Xenograft:graft taken from one individual placed on an individual belonging to another species, e.g., animal to human.
Types of grafting
[edit]The term grafting is most commonly applied toskin grafting,however many tissues can be grafted:skin,bone,nerves,tendons,neurons,blood vessels,fat,andcorneaaretissuescommonly grafted today.
Specific types include:[citation needed]
- Skin grafting – often used to treat skin loss due to awound,burn,infection,orsurgery.In the case of damaged skin, it is removed, and new skin is grafted in its place. Skin grafting can reduce the course of treatment and hospitalization needed, and can also improve function and appearance. There are two types of skin grafts:
- Split-thickness skin grafts (theepidermisand part of thedermis)
- Full-thickness skin grafts (the epidermis and the entire thickness of the dermis)
- Bone grafting– used indental implants,as well as other instances. The bone may beautologous,typically harvested from theiliac crestof thepelvis,or banked bone/allograft.[2]
- Vascular grafting– the use of transplanted or prosthetic blood vessels in surgical procedures.
- Ligament graftingrepair – as withanterior cruciate ligament reconstructionorulnar collateral ligament reconstruction.
- Fat grafting – the process of harvestingadipose tissuethroughliposuction,processing/centrifugation and injection intosoft tissuefor improving coverage, volume and contour, typically in the breast, buttock and face.[3][4]
Indications
[edit]- Large amount of skin loss due to infections
- Burns
- Skin cancer surgery[5]
- Chronicconnective tissue disease[6]
Reasons for failure
[edit]- Hematomadevelopment when the graft is placed over an active bleed
- Infection
- Seromadevelopment
- Shear force disrupting growth of new blood supply
- Inappropriate bed for new blood supply to grow from, such as cartilage, tendons, or bone
References
[edit]- ^Textbook of Microbiology, R. Vasanthakumari, p166, 2007, New Delhi,ISBN978-81-7225-234-2
- ^Le BT, Borzabadi-Farahani A (July 2014). "Simultaneous implant placement and bone grafting with particulate mineralized allograft in sites with buccal wall defects, a three-year follow-up and review of literature".Journal of Cranio-Maxillo-Facial Surgery.42(5): 552–9.doi:10.1016/j.jcms.2013.07.026.PMID24529349.
- ^Rosing JH, Wong G, Wong MS, Sahar D, Stevenson TR, Pu LL (October 2011). "Autologous fat grafting for primary breast augmentation: a systematic review".Aesthetic Plast Surg.35(5): 882–90.doi:10.1007/s00266-011-9691-2.PMID21455825.S2CID13302250.
- ^Asserson DB, Kulinich AG, Orbay H, Sahar DE (May 2019)."Differences in Complication Rates of Gluteoplasty Procedures That Utilize Autologous Fat Grafting, Implants, or Local Flaps".Ann Plast Surg.82(5S Suppl 4): S342–S344.doi:10.1097/SAP.0000000000001765.PMID30570567.S2CID58566838.
- ^"Skin graft".NIH.Retrieved18 May2015.
- ^Strong AL, Rubin JP, Kozlow JH, Cederna PS (December 2019). "Fat Grafting for the Treatment of Scleroderma".Plast Reconstr Surg.144(6): 1498–1507.doi:10.1097/PRS.0000000000006291.PMID31764674.S2CID208277267.