ABSTRACT

The skin can be harvested with a conventional handheld instrument. The two types of skin graft are full-thickness and split-thickness grafts, which should ideally be at a depth to cut across the rete pegs to enable healing. Full-thickness grafts can be harvested from the lax neck skin, post-auricular region or for larger defects, the abdomen. Oral mucosal flaps can be directly closed or be taken as local rotational and advancement flaps. As with skin flaps, excessive tension will reduce the blood supply and lead to dehiscence and infection and the flap length/width ratio should be no more than about 4:1. Bone is harvested at the time of bicoronal flap or an incision can be made over the parietal bone prominence with care being taken to avoid damaging hair follicles. There are many sites for harvesting nonvascularized grafts, but the iliac crest and costal cartilage provides a good amount of bone and cartilage, respectively, with low morbidity at the donor site.