Roller Knife Skin Removal

The required skin piece is large, and the skin piece can be cut with a roller knife. Suitable for cutting thin or medium-thick fault skins. With the improvement of the requirements for the repair of skin defects, the skin dermatosis is widely used in burns and orthopedics because of its intact skin and uniform thickness. Compared with the general roller knives, the leather drum is technically difficult and complicated, and has its own characteristics in terms of nursing cooperation. Treating diseases: burns Indication The required skin piece is large, and the skin piece can be cut with a roller knife. Suitable for cutting thin or medium-thick fault skins. Contraindications 1. Patients with severe heart, lung, liver, kidney disease and diabetes cannot undergo surgery. 2. People with potential infections in the body. Preoperative preparation 1. Improve the general condition, such as patients with anemia, low plasma protein, dehydration, etc., must be treated first. 2. The granulation wound needs to be prepared for a period of time, including unobstructed drainage, diligently changing the dressing and saline wet compress (usually wet for 2 to 3 days), proper pressure dressing, raising the affected limb, waiting for the germination color to be fresh and rosy, texture Solid edema, less secretion, no inflammation around the wound edge, can be skin grafting. If the granulation tissue is high, it is feasible to remove it. 3. Fresh wounds should be treated according to the debridement steps, so that the wounds have no active bleeding and necrotic tissue, and the edges are trimmed neatly. 4. The donor site should be shaved 1 day before surgery, brushed with soapy water, wiped dry, then rubbed with alcohol, wrapped with sterile towel, can not use strong disinfectant (such as iodine, etc.), so as not to damage the epidermis, reduce The skin is vital. Skin disinfection was performed with 1:1000 thiomersal and 75% alcohol during surgery. Surgical procedure The skin supply area is disinfected and laid. Paraffin oil is applied to the skin surface and the roller knives to facilitate smooth feeding when the skin is taken. Adjust the thickness of the skin on the roller knife. The assistant flattens the donor area by hand. The surgeon takes a knife and a skin knife at a 20-30 degree angle to start the knife-drawing action. Because the skin knife can not accurately control the thickness of the skin, the thickness of the skin piece should be paid attention to during the skin picking process. When the skin is too thin, increase the angle between the knife and the leather surface and increase the pressing force, or adjust the thickness of the blade. If the skin is too thick, the angle between the knife and the skin should be reduced and the pressure reduced to achieve the desired thickness. There is a dense point-like hemorrhage on the donor skin, indicating that the skin is thick. Cut the skin piece as needed to repair the area of the wound. The bleeding point of the wound has been fused into a piece. Wipe the skin for bleeding. The wound surface is covered with oil yarn, gauze and cotton pad, and pressure-wrapped. If there is no special condition, keep the dressing dry and do not move. After 3-4 weeks, the donor skin can heal. complication Infection, limb crushing.