Thereconstructive ladder is the set of levels of increasingly complex management of wounds in reconstructiveplastic surgery.^[1] The surgeon should start on the lowest rung and move up until a suitable technique is reached.

There are several small variations in the reconstructive ladder^[2][3] in the scientific literature, but the principles remains the same:

1. Healing by secondary intention
2. Primary closure
3. Delayed primary closure
4. Split thickness graft
5. Full thicknessskin graft
6. Tissue expansion
7. Randomflap
8. Axial flap
9. Free flap

• List of plastic surgery flaps
• Perforator flaps

• Plastic surgery