A small compilation of nurse anesthesia care plans

These anesthesia care plans are meant to inspire nurse anesthesia residents when they are making their care plans. Always make sure you fully understand and "own" your care plan. Your plan must be specific for your patient and should always be with the most up-to-date information.

Split-Thickness Skin Graft

Skin Functions

The skin is the largest single organ.

It provides protection against trauma, radiation, environment, and infection

Thermoregulation (vasodilatation and sweating vs. vasoconstriction and shivering)

Controls insensible fluid losses

Restoration is important to maintain the above functions

2 Layers

The epidermis is the top layer

  • Epidermis consists of five distinct layers - gets blood supply from the dermis

The dermis is the middle layer of the skin

  • Dermis has two main layers

The hypodermis is the bottom layer of the skin

Skin Grafts

Skin transplanted from one location to another on the same individual is termed an autograft

These grafts consist of the entire epidermis and a dermal component of variable thickness

Full-Thickness Skin Graft (FTSG)

The entire thickness of the dermis is included

Higher metabolic needs

Split-Thickness Skin Graft (STSG)

Less than the whole thickness of the dermis is included

STSGs are used to resurface large wounds and mucosal deficits, close flap donor sites and line cavities, and resurface muscle flaps

Fragile graft, when placed over the area with little soft tissue support, can contract during healing

The donor site must re-epithelialize, which can be painful and requires wound care

Common sites are the upper anterior and lateral thighs

Good wound preparation helps with graft success

Full circulation is restored to graft in 6-7 days

Graft Failure

Hematoma beneath graft, lack of lubrication by sebum produced by glands, lack of nutrition, and poor recipient site (poor vascularity/infection)

Movement of graft and/or excessive pressure/stretching can also cause failure