187. More Complex Skin Surgery

  1. Alan D. Irvine MD, FRCPI, FRCP2,3,
  2. Peter H. Hoeger MD4,5 and
  3. Albert C. Yan MD, FAAP, FAAD6,7
  1. Paul Morris MBChB, FRCS (Ed), FRCS (Plast), MD,
  2. Guy Thorburn BMBS, BMedSci, MA, FRCS(Plast) and
  3. Loshan Kangesu

Published Online: 24 MAY 2011

DOI: 10.1002/9781444345384.ch187

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition

How to Cite

Morris, P., Thorburn, G. and Kangesu, L. (2011) More Complex Skin Surgery, in Harper's Textbook of Pediatric Dermatology, Volume 1, 2, Third Edition (eds A. D. Irvine, P. H. Hoeger and A. C. Yan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444345384.ch187

Editor Information

  1. 2

    Trinity College, Dublin, Ireland

  2. 3

    Our Lady's Children's Hospital, Dublin, Ireland

  3. 4

    University of Hamburg, Hamburg, Germany

  4. 5

    Catholic Children's Hospital Wilhelmstift, Hamburg, Germany

  5. 6

    University of Pennsylvania School of Medicine, Philadelphia, PA, USA

  6. 7

    The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Author Information

  1. Department of Plastic Surgery, Great Ormond Street Hospital for Children, NHS Trust, London, UK

Publication History

  1. Published Online: 24 MAY 2011
  2. Published Print: 3 JUN 2011

ISBN Information

Print ISBN: 9781405176958

Online ISBN: 9781444345384



  • more complex skin surgery;
  • plastic surgery, congenital malformations - reconstruction, after malignancy;
  • plastic surgery teaching - concept of ‘reconstructive ladder’;
  • wound healing - distinction between primary healing;
  • surgical advantages of younger patients - better skin quality, elasticity and vascularity;
  • skin tension line position - lines of facial expression in later life;
  • scar revision - little reason for scar revision, following elective surgery;
  • Z-plasty, changing direction of scar - line of natural skin tension;
  • skin grafts, method of covering defects - large for direct closure;
  • alternative methods of soft tissue closure


This chapter contains sections titled:

  • Introduction

  • Challenges of more complex skin surgery

  • Methods of wound cover

  • Skin graft

  • Clinical applications of skin grafting in paediatric plastic surgery

  • Alternative methods of soft tissue closure

  • Conclusion

  • References