Reconstructive ladder

The reconstructive ladder is a term coined by reconstructive plastic surgeons to describe levels of increasingly complex management of wounds. [ABC of wound healing: BMJ 2006;332;710-712 Reconstructive surgery, D. E. Boyce, K. Shokrollahi]

The ladder

There are several small variations in the reconstructive ladder [ [http://student.bmj.com/back_issues/0803/education/271.html sBMJ ] ] [Orthop Clin North Am. 1993 Jul;24(3):393-409, The reconstructive ladder. An orthoplastic approach, L. Levin] in the scientific literature, but the principles remains the same: Rung 1: healing by secondary intention
Rung 2: primary closure
Rung 3: delayed primary closure
Rung 4: split thickness graft
Rung 5: full thickness skin graft
Rung 6: tissue expansion
Rung 7: random pattern flap
Rung 8: pedicled flap
Rung 9: free flap

References


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