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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Reconstructive ladder

Introduction

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

Overview

Overview

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

The ladder

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

References

  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