The reconstructive ladder is a term coined by reconstructive plastic surgeons to describe levels of increasingly complex management of wounds. The surgeon should start on the lowest rung and move up until a suitable technique is arrived at.
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 flap
Rung 8: Axial flap
Rung 9: Free flap
References
Reconstructive ladder Wikipedia(Text) CC BY-SA