Reconstructive ladder
The reconstructive ladder is the set of levels of increasingly complex management of wounds in reconstructive plastic surgery.[1] The surgeon should start on the lowest rung and move up until a suitable technique is reached.
There are several small variations in the reconstructive ladder[2][3] in the scientific literature, but the principles remains the same:
- Healing by secondary intention
- Primary closure
- Delayed primary closure
- Split thickness graft
- Full thickness skin graft
- Tissue expansion
- Random flap
- Axial flap
- Free flap
References
- ABC of wound healing: BMJ 2006;332;710-712 Reconstructive surgery, D. E. Boyce, K. Shokrollahi
- sBMJ
- Orthop Clin North Am. 1993 Jul;24(3):393-409, The reconstructive ladder. An orthoplastic approach, L. Levin
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