Reconstructive ladder

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1]; Michel C. Samson, M.D., FRCSC, FACS [2]

Overview

The reconstructive ladder is a term coined by reconstructive plastic surgeons to describe levels of increasingly complex management of wounds.^[1]

The ladder

There are several small variations in the reconstructive ladder^[2]^[3] in the scientific literature, but the principles remains the same:

Rung 1: healing by secondary intention
Rung 2: primary closure
Rung 3: delayed primary closure
Rung 4: split thickness graft
Rung 5: full thickness skin graft
Rung 6: tissue expansion
Rung 7: random pattern flap
Rung 8: pedicled flap
Rung 9: 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

[1] ABC of wound healing: BMJ 2006;332;710-712 Reconstructive surgery, D. E. Boyce, K. Shokrollahi

[2] sBMJ

[3] Orthop Clin North Am. 1993 Jul;24(3):393-409, The reconstructive ladder. An orthoplastic approach, L. Levin

[1]

[2]

[3]