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    Pre-Operative Guidelines
Operating Room Supplies
    Excision to Viable Tissue
Adequate Vascular Supply
Maintaining Meticulous Hemostasis
Uniform and Flat Bed
 
  Application
  Post-Op Care
  Summary
   


Excision - Section Summary
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In this section, you have learned:

  • An excised graft bed must be free from contamination and infection. All affected tissue must be removed. Pre-Operative routines should follow normal surgical center protocols. This may include the use of systematic broad spectrum antibiotics. If wound infection is detected, treat topically and/or systemically according to burn unit protocols.
  • Achieve an adequate vascular supply prior to the application of INTEGRA Template. As with autograft: punctate, uniform capillary bleeding indicates adequate excision of the affected tissue. Signs of a viable graft bed include: white dermis, pure yellow fat and glistening fascia.
  • The graft bed must be dry with no signs of bleeding. Meticulous hemostasis needs to be achieved to prevent hematomas or excessive fluid accumulation. Epinephrine, pinpoint electrocaudary, thrombin spray, thrombin-soaked gauze or other topical hemostats should be used. Avoid broad area cauterization which can lead to affected tissue.
  • To ensure intimate contact with INTEGRA Template the graft bed must be uniform and flat. Achieve level tissue planes and when necessary, marsupialize edges to avoid large step-offs between the wound bed and normal skin.

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