WHAT A HEALTH PRovIDER SEES
Skin G rafts and Artificial Skin
E
xtensive and severe burns can have grave consequences
for a patient's life. Ultimately, the damaged skin must be
removed, some underlying tissue may have to be recon-
structed, and new skin might have to be sutured over the
damaged area (skin graft). The skin graft a. uses donor
skin, which may come from either the patient (autologous
graft) or a cadaver (allograft). The major advantage of an
autologous graft is that the graft will not be rejected by the
patient's immune system. Recently, burn surgeons have
developed artificial skin that serves as both a bandage
and a scaffold for growing new skin. Artificial skin b. is a
lower-layer matrix consisting of collagen and
glycosaminoglycan (a carbohydrate).
The matrix mimics the dermis, and
the patient’s own dermal cells
migrate and grow into the
burned area. The upper lay-
er is made of silicone that
mimics the epidermis.
After 2 to 4 weeks, the
surgeon removes the
silicone layer and re-
places it with a layer
of epidermal cells
from another area of
the patient's body.
In time, these cells
form a normal epider-
mal layer without hair
follicles.
b. Artificial skin
1.
Follow ing a severe burn, the
skin that form s over the w ounds will have m any of
the features of the skin that had been there prior to
the burn, with the exception of hair follicles. W hy
will hair follicles be m issing in the newly form ed skin
of the burn area?
2.
Skin grafts are often taken from a sm all section
of the skin of the thigh. The skin is run through a
special instrum ent that m akes tiny cuts in the graft
tissue. The skin graft is then stretched, form ing
sm all g ap s all through the tissue, and laid onto the
burn w ound. W hat w ould be the purpose of the
sm all cuts in the skin graft? W hat will happen to the
sm all g ap s in the graft? W hy w ould it be im portant
to rem ove all the d am aged tissue from the w ound
prior to p lacing the graft?
CONCEPT CHECK
1.
How
does the skin help to regulate body
temperature?
2.
What
events happen in the healing of an
epidermal wound?
3.
Which
receptors detect touch?
4.
What
type of burn is characterized by blisters,
and why do they form?
104
CHAPTER 4
The Integumentary System
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