Dermatome (instrument)

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Schematic drawing of a dermatome
Schematic representation of the extraction of a skin flap

A dermatome (from ancient Gr . Δἐρμα derma skin and τομή tomé incision) is a surgical cutting instrument with which evenly thick skin flaps can be obtained for free transplantation . The skin areas obtained are used for trauma , chemical burns or burns. In dentistry , the mucotome is used to remove mucosal grafts.

Types of dermatomes

Dermatomes can be operated manually or electrically. In the 1930s, the first manually operated drum dermatome was developed. Compressed air and electric dermatomes work more precisely when explanting longer strips of skin with a homogeneous thickness. With the dermatome, skin areas of up to 80 square centimeters can be removed in one go. The electrodermatome, with which the skin can be peeled off in long strips, is used in the treatment of burn wounds . Manual dermatomes (e.g. Thiersch knives, Padgett's drum dermatome, Blair-Humby dermatome) are not very suitable for larger sampling points. When using the mesh or reticulated flap technique (mesh graft transplants), a split-thickness skin flap is provided with a cutting pattern by the cutting roller of a mesh graft dermatome.

Mucotome in dentistry

Analogous to the dermatome, the mucotome is used in dentistry to remove the mucosa ( mucous membrane ) that serves as a graft for gingival extension . This is used to widen the keratinized (attached) gingiva in advance of the integration of dentures (preprosthetics), for the treatment of dental implants and for teeth with diseased gums (gingival recession). A distinction is made between the Deppeler's hand mucotome , which is equipped with single-use blades of different widths (7-16 mm), and the Mörmann motor-driven mucotome , with which mucosal strips 6.5 mm wide and 0.75 mm thick can be obtained. Then, if necessary, the transplants can be cut into the required shape on a sterile glass pane under Ringer's solution with a scalpel or thinned with a mucotome.

Individual evidence

  1. ↑ Alfred Berger, Robert Hierner: Plastic surgery: Basics, principles, techniques . Springer DE, 2003, ISBN 978-3-642-55886-3 , p. 290.
  2. ↑ History of plastic surgery ( Memento of the original from November 7, 2017 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / medanss.com
  3. ↑ Split skin grafting
  4. ↑ HC Sullivan, JH Atkins: Free autogenous gingival grafts. 3. Utilization of grafts in the treatment of gingival recession. In: Periodontics. 6, No. 4, August 1968, ISSN  0553-6685 , pp. 152-160, PMID 5243142 .
  5. ↑ Uwe Eckelt: Dental, Oral and Maxillofacial Medicine: Dental Surgery: 35 tables / ed. by Norbert Schwenzer; Michael Ehrenfeld. With contrib. By Uwe Eckelt ... . Georg Thieme Verlag, 2009, ISBN 978-3-13-116964-8 , p. 203.
  6. ^ Herbert F. Wolf, Edith M. Rateitschak: Periodontology . Georg Thieme Verlag, 2004, ISBN 978-3-13-655603-0 , p. 401.