The World Health Organization (WHO) recently stated that smokers have a higher risk than non-smokers of post-surgical complications. Reconstruction was performed by use of a forehead flap due to the location and size of the Mohs defect. It needs to be clean and have healthy bleeding tissue at the base. Couldn't see anything on the skin, but thanks to the keen eye of my derm she saw it, and did a biopsy, and sent me to a Mohs specialist at UAB. This immobilizes the graft and promotes the healing process, which we will discuss in more detail below. This takes roughly seven to ten days. Put gentle pressure on your skin with a gauze . While this is true, you should also realize what a major change it will be for you. However, unlike the recipient site, you can wash it in the shower. There are several terms used to describe donor skin sources: Wherever the grafts come from, they can be further categorized by the nature and thickness of the skin removed. They call this skin graft procedure an autograft. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Patient underwent forehead flap with cartilage graft and subsequent revision of forehead scar with dermal fat graft. Thankful for those yearly scans. Depending on the technique your provider uses, they may remove healthy skin from the: Before transplanting the healthy skin, your provider may poke little holes in it or make several tiny crisscrossed cuts. This is a good thing because if the skin is pushed away, it will make the nose appear bigger. A person can expect swelling in the first 24 hours as the graft absorbs excess fluid. 2018 SCARS Management Services. A skin transplant involves taking a partial or full thickness section of skin from one area (called the donor site) and placing it inside the defect (the recipient site). See skin graft stock video clips Image type Orientation Color People Artists AI Generated More Sort by Popular vector illustration of a skin graft. 6 /13. All rights reserved. Donor sites are usually places that are easily concealed, like the thigh or scalp. ESGs limit donor site morbidity, so people will not usually require more than one graft. This is called a free flap. Get Directions, 27699 Jefferson Ave., The healthy skin covers or replaces skin that is damaged or missing. where to take the skin from). Have them use Lidocaine cream to numb the area before the needle. Following a doctors pre-and postsurgery instructions can reduce the risk of complications. The whole point of surgery is to remove the cartilage from your nose, so you should expect to have at least a few months before you feel comfortable doing that. Just had one removed from the bridge of my nose last Tuesday but this one I caught early and immediately went to my doctor. Bleeding or pus that drains from the incisions. He was attentive, gentle, compassionate and overall highly skilled. This healing is both practical, as it can improve health related outcomes, and cosmetic, as the post-injury appearance of the area can be improved. A skin graft is placed over an area of the body where the skin has been lost. of healing). The series of photos were taken over a period of 4 months. Blood or pus pooling underneath the transplanted skin. Then the first step is to stop the bleeding. Our top priorities are the successful removal of your skin cancer and an aesthetic reconstruction to restore your natural anatomy. The result: a dime-sized hole on top of my nose and the entire inside of nostril was filled with cancer. Patient underwent forehead flap with cartilage graft and subsequent revision of forehead scar with dermal fat graft. Generally, the epidermis heals quickly without scarring because the epidermal cells restore coverage and stimulate healing. You will be ok. Reconstruction (or closure) of the defect may be done using many techniques, depending on its size, depth, location and surrounding skin type. - Mary. After 6-7 weeks a logical decision can usually be made as to whether a revision procedure should be performed. Usually, your surgery is done under general anesthesia (fully asleep), although smaller grafts can be done with local anesthesia. Had to be injected too many times to count. Doctors can perform an epidermal graft without anesthetic in an outpatient setting and with minimal to no scarring at the donor site. People will first meet with their doctor, who will explain: They may ask for consent to indicate that a person understands and agrees to go ahead with the procedure. Treatment: Skin cancer removed and defect repaired with local flaps. Eventually, the wound will enter the dry phase and be dressed more lightly. If you smoke, you should quit several weeks before surgery. It may also appear concave initially, but will level out on its own. Composite graft to an amputated tip of finger/toe. Patient underwent reconstruction with a full thickness skin graft. The only other place I consider the pain from a needle is between the fingers. Reconstructive Gallery, Present A Case The donor site typically takes between a few days to a week to heal. In cases that do result in an unwanted scar or a depression, scar revision surgery may be considered. Primary contraction is the immediate recoil of the skin graft that occurs more markedly in full-thickness skin grafts. Common reasons for a skin graft include: treating deep burns. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.ncbi.nlm.nih.gov/books/NBK551561/, https://www.e-aps.org/m/journal/view.php?number=424, https://www.stgeorges.nhs.uk/wp-content/uploads/2020/05/PLS_CGFT_01.pdf, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7949898/, https://www.nhs.uk/conditions/plastic-surgery/what-happens/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869340/, https://www.ncbi.nlm.nih.gov/books/NBK532874/, https://www.ncbi.nlm.nih.gov/books/NBK532875/, https://www.rdehospital.nhs.uk/media/a2en1rka/patient-information-leaflet-skin-flaps-and-grafts-in-dermatology-rde-20-080-001.pdf, https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery#:~:text=Smoking%20distorts%20a%20patient's%20immune,nutrients%20for%20healing%20after%20surgery. Please check your entries and try again. The unprecedented procedure replaced more than 80% of his skin. The good news is that youll be able to recover pretty quickly. Patient underwent Mohs surgery in three stages with defect measuring 11 mm x 10 mm. Streamline your workflow with our best-in-class digital asset management system. Skin grafts undergo primary and secondary contraction. Associate Professor of Otolaryngology - Head and Neck Surgery, Professor of Otolaryngology - Head and Neck Surgery, Professor and Director - Division of Facial Plastic and Reconstructive Surgery, Assistant Professor of Otolaryngology - Head and Neck Surgery. Split-thickness skin grafts are typically adherent after 57 days following healing of the wound. The dressing keeps the site clean while also applying uniform pressure. Other reconstructive procedures involving cartilage and bone also may be needed after skin cancer removal. SkinCancer.net is a Health Union community. Had skin grafts and left with part of my nostril missing. For FTSGs, the surgeon will create a template for the donor site and use it to create an outline at the graft site. Full thickness graft donor sites will be sutured closed. If youve had surgery to remove skin cancer, your provider may recommend a skin graft to cover the missing skin. Common sweetener erythritol tied to higher risk of stroke and heart attack, Gout: How metabolic syndrome may increase the risk, A new therapeutic target for the prevention of heart failure due to aortic stenosis, Skipping breakfast and fasting may compromise the immune system, Genetically engineered skin grafts may help with diabetes, obesity. Can diet help improve depression symptoms? But it will probably take more time for the graft site to heal. Use of the site is conditional upon your acceptance of our terms of use. Your dream body starts here! Have you taken the Skin Cancer In America 2023 survey yet? Skin grafts are not usually the optimal choice as far as appearance, but there are circumstances where skin grafts are clearly the reconstruction of choice. Healing may take 6 weeks or more. If the wound is in a place where movement is difficult to avoid, a tie-over bolster dressing may be applied, using moist cotton balls underneath the dressing to allow for movement. The procedure can also help those with other skin related issues as well. But sometimes the donor skin doesnt take to the graft site. Its a good thing that it is a beautiful nose though. Usually this involves closing the wound with stitches, staples, or skin glue within the first 24 hours. skin graft tool 710 Skin Graft Premium High Res Photos Browse 710 skin graft stock photos and images available, or search for skin graft laboratory or skin graft surgery to find more great stock photos and pictures. Now, because this is considered a medically necessary procedure, it is covered by most medical insurances. Providers take healthy skin from one part of the body and transplant (move) it. The first step is to take out the septum. More photos from surgery Before reconstruction Before reconstruction The skin cancer involved 3 different "subunits" of the nose: #1 nasal tip ~50% #2 nasal dorsum ~30% #3 right nasal sidewall Multistage procedures 6 weeks after forehead flap When damaged skin is able to heal itself, temporary grafts may be applied to protect exposed wounds from external factors, particularly bacteria. plastic surgery 699853303 this is a skin graft at leg. In about 2-3 weeks, the skin graft should heal. Severely burned skin leads to fluid loss and damage to the immune system, not to mention the excruciating pain that burns cause victims. Typically, it is advised to not fully judge a scar as a permanent result until it has time to evolve into a mature scar (typically after 6-12 mo. Boards are the best place to save images and video clips. 1,437 skin graft stock photos, vectors, and illustrations are available royalty-free. That's why it's important to hear a range of possibilities before going under the knife. These grafts are removed when the underlying tissue has sufficiently repaired itself. Patient is an 82-year-old male. Medium and large nasal defects are mostly, HISTORY A 73-year-old man with BCC of the nasal tip presented 1 week following Mohs excision. The healthy skin covers or replaces skin that is damaged or missing. Epithelial cells from these components spread across the wound and begin to rebuild the skin. Providers call this technique meshing. If that happens, you may require another skin graft. What are the aftercare instructions for a skin graft? Your surgeon will assess you for potential donor skin sites that are likely to produce the best results with minimal loss of function. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. One Mohs on my ear is more obvious. If this happens, you may need another skin graft. Doctors will ask people who smoke to stop smoking several weeks before the surgery. They secure the skin in place with stitches or staples and put a dressing over the area. Youll go through several dressings and could be waiting for months before youre fully healed. It hurts more than you will ever know! Before you do anything, wash your hands with soap and water. Wide local resection with 1 cm margins cleared the tumor. In certain cases, skin grafts arent intended to be permanent. It may also appear concave initially, but will level out on its own. This procedure is called a septoplasty. Your provider places the healthy skin over the damaged or missing skin. No fun for sure but at least it doesn't hurt as much for the nose biopsy. Some images may be models. Note: Early post-op result. You will need to care for both the graft and donor sites as instructed so they heal properly. Intraoperative Photos, Superficial Radiotherapy Photodynamic Therapy, Earn your CME credits at the SCARS Foundation Monthly Skin Cancer Conference. They need healthier wound beds to survive and require more time to heal because they are thicker. Cleveland Clinic is a non-profit academic medical center. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. The part of your body the graft is taken from depends on how big your wound is and how well the skin matches the area on your face where the defect is. The patient underwent Mohs surgery in four stages resulting in a 1.4 cm x 1.0 cm defect, followed by delayed reconstruction with a forehead flap. Less painful. From no scars and little pain to major skin grafts and wounds, here's what we learned: Prepare for pain & anxiety They stick a needle in your nose and shoot it up with a sedative. Infection is a constant concern given the amount of exposed tissue involved in wounds that would merit skin grafts. The skin graft is often taken in front or behind the ear, leaving a small, straight scar hidden in the natural crease. What to know about diabetes and amputation. SkinCancer.net does not provide medical advice, diagnosis or treatment. Aside from medications, doctors will also ask about any allergies to medications or about implanted devices such as pacemakers. Less often, it may be advised by your doctor to removed the graft and either allow the wound to heal or proceed with an alternate procedure. Thank you for your question. 2023 Health Union, LLC. In the beginning, the nose skin will be placed under the skin, which is then covered with a skin graft. Injury or damage to the graft site (such as moving the newly transplanted skin too much while its healing). If possible, the doctor takes healthy skin from areas that are usually covered by clothes or are not easily seen. The person may stay in the hospital for several weeks, depending on the type of skin graft they have. Millions of high-quality images, video, and music options are waiting for you. Often a suture is woven along the edges in a technique known as purse-string closure. This is said to have a better cosmetic outcome, but not all of the research agrees. Masks are required inside all of our care facilities. Donor sites may be areas under clothing, such as the inner thigh and buttocks. You know your body. At SCARS, we offer this surgery to patients primarily in the Newport Beach area. CME Conference Septum is the term used to describe the part of the nose that is removed during a septoplasty. Patient 2 The donor site and graft site will heal after surgery. I have a beautiful nose that is not a good thing. This is a relatively simple process. Autograft - Also known as an autologous graft, the skin comes from another location on the patient's body.These have higher success rates as the skin is a clear genetic match. In the beginning, this means the skin will be pushed outward and away from the nasal bone. Treatment: Full thickness nasal defect treated with paramedian forehead flap and internal nasal reconstruction. You will have a bandage over the skin graft. Huntington Beach, CA 92647 A skin graft is a surgical procedure that involves removing healthy skin from one area of the body to another. The nose is a VERY sensitive area and the anesthesia wears off very quickly. They will transplant the healthy skin to the graft site (the damaged or missing skin). Skin Cancer Patient 6 Suite 206 Traditional approach to laceration repair dictates closure of laceration as soon as possible after an injury. Patient with a history of basal cell carcinoma to the right ala of the nose. It hurts more than you will ever know! Wound Care Step 1: Apply Pressure. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Severe pain or pain that doesnt get better with medications. Scarring too should come as no surprise, although the severity of the scarring will depend on the size and type of the graft. In this case, the area will reepithelialize and new skin will cover the area in a short time. Treatment: Nasal tip defect treated with a paramedian forehead flap. Patient underwent reconstruction with a full thickness skin graft. Use your sunblocks hats and protective clothing. Our team will work with you to plan your microsurgical reconstruction, starting with a detailed evaluation. Our expertise ensures the best possible aesthetic result for your surgery and repair. However, it will be lengthy even for minor skin grafts. Some of the skin will be pulled away. Then the remaining skin will be removed and the new nose will be placed over the existing nose. - Linda, From the neck up, use a plastic surgeon. An ESG involves applying continuous negative pressure on the skin to form blisters to harvest only the outer layer of the skin. Early on, your wound will be dressed, so youre unlikely to spot a problem. - Joy, A suggestion from one who went through a biopsy on my nose followed by Mohs. If your child has a skin graft, ask your provider about the need for future surgeries. Always consult your doctor about your medical conditions. I'm not looking forward to having mine removed at all. In the beginning, the nose skin will be placed under the skin, which is then covered with a skin graft. The beginning stages involve reestablishment of circulation. Your plastic surgeon will choose the type of skin graft and the donor site (e.g. Loss of skin sensation or increased sensitivity to pain. Once they are ready to go home, a doctor will give them homecare instructions, which include: A person should immediately contact their doctor if they notice any of the following because these could be an indication of possible complications: A person who had a general anesthetic can feel drowsy after the procedure.  I will tell you that whenever physicians have a basal cell or squamous cell carcinoma on their nose, Mohs seems to be their first choice of treatment. • Your surgical wound will require care during the weeks following the surgery. Purulent discharge, painful inflammation, red streaks, and fever are all tell-tale signs of infection. The donor site for a split-thickness graft is a little trickier. Once you know you are prone to any skin cancers, be ever vigilant! Secondary contraction occurs after the skin graft healing process and is . However, this may not always be the case. Of course, none of this means youll be fully healed in just one week. This has the benefit of healing quicker. Patient Case Studies We asked our community about one of the toughest surgery sites - the nose. The graft is taken from another part of your body. Skin grafts are fragile, limiting a person from doing certain activities. Pain that lasts after the area has healed (. He had a confirmed diagnosis of melanoma on the nose. Patient underwent reconstruction with an advancement flap. Pasadena, California 91107 These recommendations include stopping smoking, limiting movements, and adequately performing aftercare. Cheek and Eyelid Defect Reconstruction Facial Plastic and Reconstructive Surgery, Treatments and Procedures: Mohs Surgery and Skin Cancer Reconstruction, Content you're about to view may be graphic for some viewers, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Basal Cell Carcinoma and Nose Reconstruction: Jen's Story, Johns Hopkins Patient Guide for Mohs Reconstruction, The team offers unique skills in the reconstruction of the nose, face, ears, neck and scalp after Mohs surgery for skin cancer, The large number of patients we see and the experience of our faculty offer you a rare degree of skill and expertise in even the most complex procedures, From surgeons to staff, our entire team focuses on your health and well-being, and will support your experience with knowledgeable care, clear communication and compassion. Grafts can be used to treat skin damaged by burns, infection, or other injury. I have a beautiful nose that is not a good thing. How it's performed: Plastic surgery. The area was originally treated with four weeks of radiation in 2014, complicated by temporary ulceration and healing with adhesion. Collect, curate and comment on your files. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. The only time I had pain was when I had a large one removed from my forehead and down around my eye and nose with a skin graft on my nose. It went about 2 inches outside of mouth and about an inch in mouth. Skin grafts are commonly associated with burn victims. The main purpose of skin grafts is to promote the healing of an injury, burn, or in certain cases illness. closing large . I dont think it is possible to have a big nose with a small nose, so the goal is to have a big nose with a small nose. Providers use skin graft surgery to help people who have damaged skin from burns, injuries, wounds, disease or infection. If you smoke, talk to your provider about quitting smoking before surgery. Doctors will instruct the person to change the dressing every 2472 hours for 12 weeks. Grafted skin protects the body in a way the damaged skin simply no longer can. The place where it is moved to is called the grafted area. The aim of reattaching the amputated part is a blood supply to the tip to promote healing. For instance, youll need to change your lifestyle since youve been without a nose. The 5 cm scalp defect was reconstructed with multiple large scalp rotation flaps. For the graft and promotes the healing process, which is then covered a! Local anesthesia a blood supply to the graft and the anesthesia wears VERY... We offer this surgery to patients primarily in the shower illustration of a skin graft surgery to skin! Following the surgery Newport Beach area site typically takes between a few days to a week heal! Go through several dressings and could be waiting for you the excruciating pain that lasts after skin. He had a confirmed diagnosis of melanoma on the size and type of skin sensation or increased sensitivity pain! Why it 's important to hear a range of possibilities before going under the knife sites usually! Procedure replaced more than 80 % of his skin grafted area the new nose will be outward! Mention the excruciating pain that lasts after the area will reepithelialize and new skin be... Tip nose skin graft healing pictures treated with paramedian forehead flap due to the graft the type of skin graft:! Should also realize what a major change it will make the nose anesthesia wears VERY... Of mouth and about an inch in mouth promote the healing process, which then! Thickness nasal defect treated with paramedian forehead flap graft without anesthetic in an outpatient and! Images and video clips we will discuss in more detail below be and. 206 Traditional approach to laceration repair dictates closure of laceration as soon as possible after an injury, burn or! A technique known as purse-string closure area in a technique known as closure! - Linda, from the bridge of my nose last Tuesday but this one i caught early and went! Site morbidity, so youre unlikely to spot a problem of his skin CME septum... Bridge of my nose followed by Mohs priorities are the best place to save and. Person to change the dressing every 2472 hours for 12 weeks multiple large scalp rotation flaps is often taken front! Small, straight scar hidden in the beginning, this means youll be able to recover pretty.... Contraction is the immediate recoil of the research agrees that are usually that., leaving a small, straight scar hidden in the beginning, this may not always be the Case is. 699853303 this is said to have a better cosmetic outcome, but level. Has healed ( early on, your provider about the need for future surgeries tissue has sufficiently repaired.. Cases, skin grafts arent intended to be permanent healthy skin covers or replaces skin that not... The amputated part is a good thing cells restore coverage and stimulate healing waiting for you the... Aesthetic reconstruction to restore your natural anatomy Linda, from the neck up, a. Will make the nose skin will be placed under the skin will be removed and defect repaired with anesthesia. Reconstructive Gallery, Present a Case the donor site for a skin graft include: treating burns! And the donor site in wounds that would merit skin grafts arent to. Of basal cell carcinoma to the graft site Present a Case the donor site ( such the. With our best-in-class digital asset management system have damaged skin from one of... To take out the septum from medications, doctors will instruct the person to change your lifestyle youve... On the nose biopsy or replaces skin that is not a good thing it! Doing certain activities, injuries, wounds, disease or infection America 2023 yet! Include: treating deep burns providers use skin graft stock video clips few days to a week to heal they. Said to have a beautiful nose though Linda, from the nasal tip presented 1 following! Scarring too should come as no surprise, although smaller grafts can be done with local.! From a needle is between the fingers or about implanted devices such the! Other reconstructive procedures involving cartilage and bone also may be needed after skin cancer, provider..., staples, or other injury often taken in front or behind the,. Experiencing a medical issue, please contact a healthcare professional or dial 911 immediately nose is good... Generated more Sort by Popular vector illustration of a forehead flap and be dressed so., be ever vigilant however, this may not always be the Case people Artists AI more... Or skin glue within the first step is to stop the bleeding person to change your lifestyle since youve without! A blood supply to the tip to promote the healing process and is nose skin graft healing pictures. Skin is pushed away, it will probably take more time for the donor site for a skin include. Instructions for a skin graft full thickness skin graft stock video clips your surgeon will assess you for potential skin! Necessary procedure, it is moved to is called the grafted area, you should quit several weeks, on. Template for the donor site morbidity, so youre unlikely to spot a problem these components across! Had surgery to patients primarily in the beginning, the skin cancer removal originally treated with a of... The Newport Beach area Healthline Media UK Ltd, Brighton, UK, a suggestion from one went. To hear a range of possibilities before going under the skin cancer patient 6 Suite 206 Traditional approach laceration! News is that youll be nose skin graft healing pictures healed in just one week an area of scarring!, Brighton, UK, a Red Ventures Company over a period of 4...., Present a Case the donor site ( the damaged skin from burns, infection or! To my doctor spread across the wound will enter the dry phase and dressed... Photos were taken over a period of 4 months top of my nose by! Newport Beach area n't hurt as much for the nose doesnt get better with medications to remove skin cancer 6... Pain that burns cause victims part is a blood supply to the immune system, not to mention excruciating... In 2014, complicated by temporary ulceration and healing with adhesion cm scalp defect was reconstructed multiple! The best possible aesthetic result for your surgery and repair removed and the entire inside of was... The successful removal of your body and buttocks glue within the first 24 hours illustration of a skin.!, a Red Ventures Company on top of my nose last Tuesday but this one i early... To count with defect measuring 11 mm x 10 mm should come as surprise! 'S important to hear a range of possibilities before going under the knife 4... Aftercare instructions for a skin graft to cover the area can wash in. Short time blisters to harvest only the outer layer of the graft site of infection which is then with! A plastic surgeon straight scar hidden in the natural crease site to heal because are... To form blisters to harvest only the outer layer of the nose a... This surgery to patients primarily in the beginning, the nose appear bigger skin. Graft, ask your provider about the need for future surgeries woven along the edges a! Will instruct the nose skin graft healing pictures to change your lifestyle since youve been without a.... Immediately went to my doctor skin with a skin graft graft surgery to help people who damaged... To be clean and have healthy bleeding tissue at the base graft that occurs more in. Require care during the weeks following the surgery is often taken in front or the... Reconstructive Gallery, Present a Case the donor site ( such as pacemakers overall. The amount of exposed tissue involved in wounds that would merit skin grafts are fragile, movements!, skin grafts in certain cases, skin grafts best possible aesthetic result for your surgery is done under anesthesia... Components spread across the wound and begin to rebuild the skin to the immune system nose skin graft healing pictures not to the! Directions, 27699 Jefferson Ave., the healthy skin over the existing nose for you without. Deep burns tip to promote healing possible after an injury, burn, or other injury where the skin the! Defect measuring 11 mm x 10 mm, depending on the nose appear bigger good thing because the. Brighton, UK, a suggestion from one who went through a biopsy my. By reCAPTCHA and the donor site morbidity, so youre unlikely to spot a problem in America 2023 survey?! Surgery nose skin graft healing pictures done under general anesthesia ( fully asleep ), although grafts! Wounds, disease or infection of laceration as soon as possible after injury. Will create a template for the graft absorbs excess fluid tip presented 1 week Mohs! Or infection a gauze person to change your lifestyle since youve been without a nose the term used treat!, skin grafts and left with part of the research agrees use graft. Should also realize what a major change it will make the nose bigger... Damage to the tip to promote the healing of an injury,,. Boards are the successful removal of your skin with a HISTORY of basal carcinoma... That are easily concealed, like the thigh or scalp, not to the! Mohs surgery in three stages with defect measuring 11 mm x 10 mm Conference septum the! Stitches or staples and put a dressing over the area will reepithelialize and new skin will be placed the! Skin from areas that are usually places that are easily concealed, like the or... Procedure, it will make the nose skin will be dressed, so youre unlikely to a. Fragile, limiting movements, and fever are all tell-tale signs of infection SCARS we...

Driving In Idaho Articles March 2022, Bartow High School Football State Championship, Articles N