Reconstructive ladder

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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.

The ladder

There are several small variations in the reconstructive ladder 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

Cleft lip and palate Microchapters
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