Things you will need:
-Dermatome
-Artiss (4mL)-make sure the OR staff starts thawing this as soon as they get it in the room
-Mepilex Ag (Largest piece they can get)
-XL Tegaderm
-Kerlex, ACE
-Epinephrine soaked Telfa
-Chromic suture
-Adaptic
-Silver wound vac
Once you harvest and mesh the skin graft, spray the Artiss into the wound bed right before you put the skin graft down. Artiss is a fibrin glue that works to adhere the skin graft to the wound bed. You can spray what you have left onto the donor site. If you want you can still throw a few simple interrupted chromics in to further tack down the graft. For the Graft dressing make sure to put adaptic down on top of the skin graft before putting on thesilver wound vac. The wound vac should stay in place for 5 days. At day 5 you can switch to adaptic with bacitracin dressings daily.
Immediately, after harvesting the skin graft you can apply epi-soaked telfa to the donor site to help decrease bleeding. For the dressing of the donor site, apply the Mepilex Ag directly to the donor site (you will see the gray sponge has a sticky side-sticky side goes on the wound) Cover this with the XL tegaderm. Wrap with kerlix and ACE bandage. The mepilex Ag can also stay in place for 5-7 days. Warn the patient that the donor site will ooze a lot. When the blood mixes with the silver in the mepilex it turns black. We always warn ppl bc they freak out. If it does ooze a lot just reinforce with another ace or add ABDs.
Published 9/4/17 (A Bernard); reviewed 9/26/24 (A Bernard)
