Grafts in Plastic Surgery

The history of plastic surgery is intimately connected with the development of knowledge and practice of grafting. Even though the graft take process has been largely studied in skin grafts, it is a complex biologic process that, in some way, still remains unclear. Two main phases can be distinguished: imbibition and revascularization. The understanding of the physiology of revascularization guides the surgical technique and clinical management of grafts. Grafted tissue may vary in viability according to many factors, which must be evaluated prior to intervention. Mastering grafting techniques depends mainly on the type of graft, the recipient sites, and the structural needs of the reconstructed area. The characteristics of the patient also affect graft survival. Optimizing vascularity and stability with the recipient site appears to be the main concern in graft surgery. Tissue engineering has demonstrated promising results for creating artificial grafts in a laboratory setting, but only a few could be clinically translated with success.