Surgical Education in Limited Resource Settings: Performing a Manual Split-Thickness Skin Graft

The latest Touch Surgery™ simulation is the next in a series of collaborations with the directors of Global Surgery Amsterdam and surgeons at Amsterdam University Medical Centres, Jurre van Kesteren, MD and Matthijs Botman, MD, and Global Health and Tropical Medicine Doctor at Masanga Hospital Sierra Leone, Jonathan Vas Nunes, MD. The module demonstrates a manual split-thickness skin graft using instrumentation available at a low cost, as well as information on accessible and safe anesthesia techniques. The module combines intraoperative video-based footage and computer-generated graphics to demonstrate the steps of the procedure.

What may start as a small infection, left untreated, could become severe and require surgical intervention if it loses its protective layer of skin. A skin graft procedure uses healthy skin from a donor site and transplants it to the affected area of the body. Our simulation follows the care pathway for a patient with an untreated dental abscess, using healthy skin from the patient’s upper thighs as donor tissue. We demonstrate manual skin harvesting with an adjustable hand dermatome, manual graft meshing, recipient site preparation, graft fixation, and wound dressing.