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In this chapter, we shall look into the pre-requisites for a successful skin grafting. This includes patient selection, identifying various factors—patient related, environment related, treatment related, and optimizing them for a successful outcome. Avoiding/removing the adverse factors and improving the wound bed environment require knowledge, experience, and checklist to be followed, so as not to miss any of these pre-requisites. This would ensure complete take of the skin graft, with good reconstructive and esthetic outcome. Various factors include patients\' general health, comorbidities, etiology of wound, duration and contamination, granulation tissue, local wound blood supply, wound sepsis, edema, vascular disease, wound bacteriology culture sensitivity, etc. The ultimate goal of improving success of skin grafting will lead to early recovery of patient, reducing hospital stay, burden on health infrastructure, and reduced loss of workdays, thereby reducing the socioeconomic impact of wound.

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Intermaxillary fixation (IMF) is a basic and fundamental principle in the management of patients with fractures of the maxillomandibular complex. There are several shortcomings related to the conventionally recommended tooth-mounted devices that are used to achieve IMF. To circumvent these, the use of bone-borne screws has been advocated. We present a series of maxillary fractures treated with IMF screws. Over a 12-month period, 15 cases of maxillary fracture were managed with open reduction and bone plate fixation. IMF screws were used to achieve IMF intraoperatively and for a short duration postoperatively. Eight cortical titanium screws were inserted transmucosally, two for each quadrant at the junction of the attached and mobile mucosa. Satisfactory occlusion was achieved in all the patients with few complications. IMF screw fixation was observed to be a safe and quick method for open reduction of maxillary fractures. Tooth-borne devices are associated with problems such as poor oral hygiene and periodontal health, extrusion of teeth, loss of tooth vitality, traumatic ulcers of buccal and labial mucosa, and needle stick injury to the operator. These procedures are also time consuming. The use of cortical bone screws is a quicker and safe alternative for achieving satisfactory IMF.