Types of Skin Graft

import urllib.request
import os
from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, Image, KeepTogether
)
from reportlab.platypus.flowables import HRFlowable
from reportlab.graphics.shapes import Drawing, Rect, String, Line
from reportlab.graphics import renderPDF

OUTPUT = "/tmp/workspace/skin-graft-pdf/Types_of_Skin_Graft.pdf"

# ── Download diagrams ─────────────────────────────────────────────────────────
img_dir = "/tmp/workspace/skin-graft-pdf/imgs"
os.makedirs(img_dir, exist_ok=True)

imgs = {
    "anatomy": "https://cdn.orris.care/cdss_images/f959600fd7372d62892ac2eca8898e07c0d5dcfd5f87fa99215a86e92c88e54a.png",
    "cross":   "https://cdn.orris.care/cdss_images/4ba1b93738d679554068854c6cd0cdf895ef4c3a0df2b509da7aa270b0e4154c.png",
}
for name, url in imgs.items():
    path = os.path.join(img_dir, f"{name}.png")
    if not os.path.exists(path):
        try:
            urllib.request.urlretrieve(url, path)
            print(f"Downloaded {name}")
        except Exception as e:
            print(f"Failed {name}: {e}")

# ── Colour palette ────────────────────────────────────────────────────────────
TEAL      = colors.HexColor("#1A6B72")
LIGHT_TEAL = colors.HexColor("#E8F5F6")
DARK_TEAL  = colors.HexColor("#0D4A50")
GOLD       = colors.HexColor("#C8861A")
LIGHT_GOLD = colors.HexColor("#FDF3E0")
GREY_LIGHT = colors.HexColor("#F5F5F5")
GREY_MED   = colors.HexColor("#CCCCCC")
DARK_GREY  = colors.HexColor("#333333")
WHITE      = colors.white
RED_SOFT   = colors.HexColor("#C0392B")
GREEN_SOFT = colors.HexColor("#27AE60")

# ── Document setup ────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    leftMargin=2*cm, rightMargin=2*cm,
    topMargin=2.5*cm, bottomMargin=2.5*cm,
    title="Types of Skin Graft",
    author="Orris Medical Reference",
)

W = A4[0] - 4*cm   # usable width

# ── Styles ────────────────────────────────────────────────────────────────────
base = getSampleStyleSheet()

def S(name, **kw):
    return ParagraphStyle(name, **kw)

title_style = S("Title",
    fontName="Helvetica-Bold", fontSize=22, textColor=WHITE,
    alignment=TA_CENTER, spaceAfter=4)

subtitle_style = S("Subtitle",
    fontName="Helvetica", fontSize=11, textColor=LIGHT_TEAL,
    alignment=TA_CENTER, spaceAfter=6)

h1 = S("H1",
    fontName="Helvetica-Bold", fontSize=13, textColor=DARK_TEAL,
    spaceBefore=14, spaceAfter=4, borderPad=4)

h2 = S("H2",
    fontName="Helvetica-Bold", fontSize=11, textColor=TEAL,
    spaceBefore=10, spaceAfter=3)

body = S("Body",
    fontName="Helvetica", fontSize=9.5, textColor=DARK_GREY,
    leading=14, spaceAfter=4, alignment=TA_JUSTIFY)

bullet = S("Bullet",
    fontName="Helvetica", fontSize=9.5, textColor=DARK_GREY,
    leading=13, leftIndent=12, bulletIndent=0, spaceAfter=2)

note = S("Note",
    fontName="Helvetica-Oblique", fontSize=8.5, textColor=colors.HexColor("#666666"),
    leading=12, spaceAfter=4, alignment=TA_CENTER)

caption = S("Caption",
    fontName="Helvetica-Oblique", fontSize=8, textColor=colors.HexColor("#555555"),
    alignment=TA_CENTER, spaceAfter=6)

table_header = S("TH",
    fontName="Helvetica-Bold", fontSize=8.5, textColor=WHITE,
    alignment=TA_CENTER, leading=11)

table_cell = S("TC",
    fontName="Helvetica", fontSize=8.5, textColor=DARK_GREY,
    alignment=TA_CENTER, leading=11)

table_cell_l = S("TCL",
    fontName="Helvetica", fontSize=8.5, textColor=DARK_GREY,
    alignment=TA_LEFT, leading=11)

adv_style = S("Adv",
    fontName="Helvetica", fontSize=9, textColor=colors.HexColor("#1A5C1A"),
    leading=13, leftIndent=10, spaceAfter=2)

dis_style = S("Dis",
    fontName="Helvetica", fontSize=9, textColor=RED_SOFT,
    leading=13, leftIndent=10, spaceAfter=2)

# ── Helper flowables ──────────────────────────────────────────────────────────
def hr(color=GREY_MED, thickness=0.5):
    return HRFlowable(width="100%", thickness=thickness, color=color, spaceAfter=4, spaceBefore=4)

def section_banner(text, color=TEAL, text_color=WHITE):
    """A coloured banner row acting as a section header."""
    t = Table([[Paragraph(text, S("BannerText",
        fontName="Helvetica-Bold", fontSize=12, textColor=text_color, leading=14))]],
        colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), color),
        ("TOPPADDING",   (0,0), (-1,-1), 7),
        ("BOTTOMPADDING",(0,0), (-1,-1), 7),
        ("LEFTPADDING",  (0,0), (-1,-1), 10),
    ]))
    return t

def info_box(text, bg=LIGHT_TEAL, border=TEAL):
    t = Table([[Paragraph(text, S("IB",
        fontName="Helvetica", fontSize=9.5, textColor=DARK_GREY, leading=14))]], colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND",   (0,0), (-1,-1), bg),
        ("BOX",          (0,0), (-1,-1), 1, border),
        ("TOPPADDING",   (0,0), (-1,-1), 8),
        ("BOTTOMPADDING",(0,0), (-1,-1), 8),
        ("LEFTPADDING",  (0,0), (-1,-1), 10),
        ("RIGHTPADDING", (0,0), (-1,-1), 10),
    ]))
    return t

def two_col_adv_dis(advantages, disadvantages):
    """Side-by-side advantages / disadvantages table."""
    adv_items = "\n".join([f"• {a}" for a in advantages])
    dis_items  = "\n".join([f"• {d}" for d in disadvantages])

    adv_p = Paragraph(
        "<b><font color='#1A5C1A'>✔ Advantages</font></b><br/>" +
        "<br/>".join([f"<font color='#1A5C1A'>• {a}</font>" for a in advantages]),
        S("AdvBox", fontName="Helvetica", fontSize=9, textColor=DARK_GREY, leading=13))
    dis_p = Paragraph(
        "<b><font color='#C0392B'>✘ Disadvantages</font></b><br/>" +
        "<br/>".join([f"<font color='#C0392B'>• {d}</font>" for d in disadvantages]),
        S("DisBox", fontName="Helvetica", fontSize=9, textColor=DARK_GREY, leading=13))

    col = (W - 0.4*cm) / 2
    t = Table([[adv_p, dis_p]], colWidths=[col, col], hAlign="LEFT")
    t.setStyle(TableStyle([
        ("BACKGROUND",   (0,0), (0,-1), colors.HexColor("#EAF7EA")),
        ("BACKGROUND",   (1,0), (1,-1), colors.HexColor("#FDECEA")),
        ("BOX",          (0,0), (0,-1), 0.5, GREEN_SOFT),
        ("BOX",          (1,0), (1,-1), 0.5, RED_SOFT),
        ("TOPPADDING",   (0,0), (-1,-1), 8),
        ("BOTTOMPADDING",(0,0), (-1,-1), 8),
        ("LEFTPADDING",  (0,0), (-1,-1), 8),
        ("RIGHTPADDING", (0,0), (-1,-1), 8),
        ("VALIGN",       (0,0), (-1,-1), "TOP"),
        ("COLPADDING",   (0,0), (-1,-1), 4),
    ]))
    return t

# ── Content builder ───────────────────────────────────────────────────────────
story = []

# ─── Cover banner ─────────────────────────────────────────────────────────────
cover = Table(
    [[Paragraph("TYPES OF SKIN GRAFT", title_style)],
     [Paragraph("A Comprehensive Surgical Reference", subtitle_style)],
     [Paragraph("Sources: Bailey & Love's Surgery 28e  |  Pfenninger & Fowler's Primary Care  |  Fischer's Mastery of Surgery  |  Dermatology 5e", note)]],
    colWidths=[W]
)
cover.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), TEAL),
    ("TOPPADDING",    (0,0), (-1,-1), 12),
    ("BOTTOMPADDING", (0,0), (-1,-1), 10),
    ("LEFTPADDING",   (0,0), (-1,-1), 14),
    ("RIGHTPADDING",  (0,0), (-1,-1), 14),
]))
story.append(cover)
story.append(Spacer(1, 0.5*cm))

# ─── Definition box ───────────────────────────────────────────────────────────
story.append(info_box(
    "<b>Definition:</b> A skin graft is tissue transferred from a donor site to a recipient wound "
    "<b>without bringing its own blood supply</b>. It depends entirely on the vascularity of the "
    "recipient bed for 'take' (revascularisation). Graft failure occurs from shear forces, "
    "haematoma/seroma formation, or infection (notably beta-haemolytic streptococci, staphylococci, Pseudomonas)."
))
story.append(Spacer(1, 0.35*cm))

# ─── Classification by donor source ───────────────────────────────────────────
story.append(section_banner("1. CLASSIFICATION BY DONOR SOURCE"))
story.append(Spacer(1, 0.2*cm))

donor_data = [
    [Paragraph("<b>Type</b>", table_header), Paragraph("<b>Source</b>", table_header),
     Paragraph("<b>Key Notes</b>", table_header)],
    [Paragraph("Autograft", table_cell), Paragraph("Same individual", table_cell_l),
     Paragraph("Gold standard — no rejection risk", table_cell_l)],
    [Paragraph("Allograft (Homograft)", table_cell), Paragraph("Cadaveric human donor", table_cell_l),
     Paragraph("Temporary; eventually rejected by immune system", table_cell_l)],
    [Paragraph("Xenograft (Heterograft)", table_cell), Paragraph("Different species (e.g., pig)", table_cell_l),
     Paragraph("Temporary biological dressing only", table_cell_l)],
    [Paragraph("Synthetic / Dermal Substitute", table_cell), Paragraph("Manufactured (e.g., Integra, MatriDerm, BTM)", table_cell_l),
     Paragraph("Requires well-vascularised bed; usually needs secondary STSG", table_cell_l)],
]
col_w = [3.8*cm, 4.5*cm, W - 8.3*cm]
dt = Table(donor_data, colWidths=col_w)
dt.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  TEAL),
    ("BACKGROUND",    (0,1), (-1,1),  GREY_LIGHT),
    ("BACKGROUND",    (0,2), (-1,2),  WHITE),
    ("BACKGROUND",    (0,3), (-1,3),  GREY_LIGHT),
    ("BACKGROUND",    (0,4), (-1,4),  WHITE),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [GREY_LIGHT, WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.5, GREY_MED),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, GREY_MED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(dt)
story.append(Spacer(1, 0.4*cm))

# ─── Classification by thickness heading ──────────────────────────────────────
story.append(section_banner("2. CLASSIFICATION BY THICKNESS (PRIMARY SURGICAL CLASSIFICATION)"))
story.append(Spacer(1, 0.2*cm))

# Diagrams
anatomy_path = os.path.join(img_dir, "anatomy.png")
cross_path   = os.path.join(img_dir, "cross.png")

if os.path.exists(anatomy_path) and os.path.exists(cross_path):
    img1 = Image(anatomy_path, width=8*cm, height=7*cm, kind="proportional")
    img2 = Image(cross_path,   width=6*cm, height=7*cm, kind="proportional")
    cap1 = Paragraph("Fig 1. Skin anatomy and harvesting depths<br/><i>(Bailey & Love's 28e)</i>", caption)
    cap2 = Paragraph("Fig 2. STSG vs FTSG cross-section<br/><i>(Pfenninger & Fowler's)</i>", caption)
    img_table = Table([[img1, img2]], colWidths=[W*0.55, W*0.45])
    cap_table = Table([[cap1, cap2]], colWidths=[W*0.55, W*0.45])
    img_table.setStyle(TableStyle([
        ("VALIGN",  (0,0), (-1,-1), "MIDDLE"),
        ("ALIGN",   (0,0), (-1,-1), "CENTER"),
    ]))
    cap_table.setStyle(TableStyle([
        ("ALIGN",  (0,0), (-1,-1), "CENTER"),
    ]))
    story.append(img_table)
    story.append(cap_table)
    story.append(Spacer(1, 0.3*cm))

# ─── STSG ─────────────────────────────────────────────────────────────────────
story.append(KeepTogether([
    section_banner("A. SPLIT-THICKNESS SKIN GRAFT (STSG / Thiersch Graft)", color=DARK_TEAL),
    Spacer(1, 0.15*cm),
    info_box(
        "<b>Composition:</b> Epidermis + a variable portion of dermis (not full dermis). "
        "Remaining dermis at donor site regenerates spontaneously.<br/>"
        "<b>Harvesting:</b> Electric/battery dermatome at 45-60° with even pressure. "
        "Common donor sites: thigh, scalp. Dermatome at 0.2-0.3 mm (0.014-0.016 inch). "
        "After harvest, donor site shows light punctuate bleeding (papillary dermis only - "
        "fat lobules must NOT be visible).",
        bg=LIGHT_TEAL, border=TEAL),
    Spacer(1, 0.2*cm),
]))

# Sub-grades
grade_data = [
    [Paragraph("<b>Grade</b>", table_header), Paragraph("<b>Thickness</b>", table_header),
     Paragraph("<b>Key Property</b>", table_header)],
    [Paragraph("Thin", table_cell), Paragraph("0.005 - 0.010 inch", table_cell),
     Paragraph("Fastest vascularisation; heals rapidly; poor cosmesis", table_cell_l)],
    [Paragraph("Medium", table_cell), Paragraph("0.010 - 0.015 inch", table_cell),
     Paragraph("Balance of take rate and cosmetic appearance", table_cell_l)],
    [Paragraph("Thick", table_cell), Paragraph("> 0.015 inch", table_cell),
     Paragraph("Better cosmesis and wear resistance; slower healing", table_cell_l)],
]
gt = Table(grade_data, colWidths=[3*cm, 4*cm, W - 7*cm])
gt.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  DARK_TEAL),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [GREY_LIGHT, WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.5, GREY_MED),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, GREY_MED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(Paragraph("Sub-grades by thickness:", h2))
story.append(gt)
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph("Meshing:", h2))
story.append(info_box(
    "STSGs can be <b>meshed</b> or <b>pie-crusted</b> (small slits cut into the graft) to expand "
    "coverage by 1.5x to 9x (ratios 1:1.5, 1:2, 1:3, 1:6, 1:9). Meshing allows drainage of blood/serum "
    "and improves graft 'take' over large defects such as burns.",
    bg=LIGHT_GOLD, border=GOLD))
story.append(Spacer(1, 0.2*cm))

story.append(two_col_adv_dis(
    advantages=[
        "Can cover large areas; can be meshed for greater expansion",
        "Requires less recipient-bed vascularity",
        "Donor site heals by secondary intention (~2 weeks)",
        "Thin grafts vascularize quickly",
        "Can act as a 'window' for tumour recurrence surveillance",
    ],
    disadvantages=[
        "High contraction risk — avoid over joints",
        "Poor cosmetic match (colour, texture, hair growth)",
        "Mesh pattern permanent — avoid face/anterior neck",
        "Less durable; prone to friction injury",
        "Will not grow over bone without periosteum",
        "Requires a dermatome; operating suite for large grafts",
    ]
))
story.append(Spacer(1, 0.15*cm))
story.append(Paragraph(
    "<b>Best for:</b> Large wounds, burns, trauma reconstruction, high-risk tumour sites.",
    S("Pref", fontName="Helvetica-BoldOblique", fontSize=9.5,
      textColor=DARK_TEAL, spaceAfter=6)))

story.append(Spacer(1, 0.3*cm))

# ─── FTSG ─────────────────────────────────────────────────────────────────────
story.append(KeepTogether([
    section_banner("B. FULL-THICKNESS SKIN GRAFT (FTSG / Wolfe Graft)", color=colors.HexColor("#5B2C6F")),
    Spacer(1, 0.15*cm),
    info_box(
        "<b>Composition:</b> Epidermis + entire dermis. Retains dermal elasticity, minimal contracture. "
        "Harvested by sharp scalpel dissection. Donor site must be <b>primarily closed</b>, limiting graft size.<br/>"
        "<b>Common donor sites:</b> Post-auricular region (classic Wolfe graft), groin crease, "
        "supraclavicular skin, inner upper arm — all areas with sufficient skin laxity.",
        bg=colors.HexColor("#F5EEF8"), border=colors.HexColor("#5B2C6F")),
    Spacer(1, 0.2*cm),
]))

story.append(two_col_adv_dis(
    advantages=[
        "Excellent colour, contour and texture match",
        "Minimal secondary contracture",
        "More durable; resists friction and wear",
        "Can cover bone without periosteum",
        "Better sensation and adnexal function",
    ],
    disadvantages=[
        "Limited by donor site size — cannot be meshed",
        "Requires excellent recipient bed vascularity",
        "Takes the longest time to vascularize",
        "Time-consuming; technically demanding",
        "Large donor sites may need STSG coverage",
    ]
))
story.append(Spacer(1, 0.15*cm))
story.append(Paragraph(
    "<b>Best for:</b> Facial defects, syndactyly release (hand), joints (contracture prevention), contracture release post-burns.",
    S("Pref2", fontName="Helvetica-BoldOblique", fontSize=9.5,
      textColor=colors.HexColor("#5B2C6F"), spaceAfter=6)))

story.append(Spacer(1, 0.3*cm))

# ─── Composite ────────────────────────────────────────────────────────────────
story.append(KeepTogether([
    section_banner("C. COMPOSITE GRAFT", color=GOLD),
    Spacer(1, 0.15*cm),
    info_box(
        "<b>Composition:</b> Skin + another tissue type (cartilage, fat, or perichondrium).<br/>"
        "<b>Example:</b> Skin-cartilage graft from helical root of ear to reconstruct nasal alar "
        "after skin cancer excision. Hair-bearing composite scalp graft to reconstruct eyebrow.<br/>"
        "<b>Limitation:</b> Best for defects <b>&lt;2 cm</b> in diameter. Higher failure risk under "
        "vascular compromise.",
        bg=LIGHT_GOLD, border=GOLD),
    Spacer(1, 0.2*cm),
]))

story.append(two_col_adv_dis(
    advantages=[
        "Single-stage procedure",
        "Good functional and aesthetic results for small defects",
        "Provides structural support (cartilage component)",
        "Low contraction risk",
    ],
    disadvantages=[
        "Size limited to <2 cm diameter",
        "High failure risk under vascular compromise",
        "Limited donor tissue availability",
        "Increased infection and displacement risk",
        "Donor site may need flap or complex closure",
    ]
))
story.append(Spacer(1, 0.3*cm))

# ─── Perichondrial cutaneous graft ────────────────────────────────────────────
story.append(KeepTogether([
    section_banner("D. PERICHONDRIAL CUTANEOUS GRAFT", color=colors.HexColor("#17A589")),
    Spacer(1, 0.15*cm),
    info_box(
        "Contains skin with its underlying perichondrium. "
        "<b>Indication:</b> Repair of deep nasal tip and alar defects, especially with exposed cartilage. "
        "Thicker than FTSG; contracts less; better chance of survival under vascular compromise.",
        bg=colors.HexColor("#E8F8F5"), border=colors.HexColor("#17A589")),
]))

story.append(Spacer(1, 0.4*cm))

# ─── Comparison table ─────────────────────────────────────────────────────────
story.append(section_banner("3. COMPARISON TABLE (Dermatology 5e — Table 148.1)"))
story.append(Spacer(1, 0.2*cm))

headers = ["Property", "FTSG", "STSG", "Composite"]
rows = [
    ["Tissue match",         "Good-Excellent",  "Poor-Fair",      "Good"],
    ["Nutritional req.",     "High",            "Low",            "High"],
    ["Vascularity req.",     "High",            "Low",            "Very High"],
    ["Contraction risk",     "Low",             "High",           "Low"],
    ["Durability",           "Good-Excellent",  "Fair-Good",      "Fair"],
    ["Sensation",            "Good",            "Fair",           "Fair"],
    ["Adnexal functions",    "Excellent",       "Poor",           "Good"],
]

comp_data = [[Paragraph(f"<b>{h}</b>", table_header) for h in headers]]
for i, row in enumerate(rows):
    bg = GREY_LIGHT if i % 2 == 0 else WHITE
    comp_data.append([Paragraph(row[j],
        table_cell_l if j == 0 else table_cell) for j in range(4)])

cw = [4*cm, (W-4*cm)/3, (W-4*cm)/3, (W-4*cm)/3]
ct = Table(comp_data, colWidths=cw)
ct.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  TEAL),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [GREY_LIGHT, WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.5, GREY_MED),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, GREY_MED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(ct)
story.append(Spacer(1, 0.4*cm))

# ─── Donor site table ─────────────────────────────────────────────────────────
story.append(section_banner("4. DONOR SITE SUMMARY"))
story.append(Spacer(1, 0.2*cm))

ds_data = [
    [Paragraph(h, table_header) for h in ["Graft Type", "Typical Donor Sites", "Donor Site Healing"]],
    [Paragraph("Thin STSG", table_cell),
     Paragraph("Thigh, scalp", table_cell_l),
     Paragraph("Secondary intention (~2 weeks)", table_cell_l)],
    [Paragraph("Thick STSG", table_cell),
     Paragraph("Thigh, back", table_cell_l),
     Paragraph("Secondary intention (slower)", table_cell_l)],
    [Paragraph("FTSG", table_cell),
     Paragraph("Post-auricular, groin crease, supraclavicular", table_cell_l),
     Paragraph("Primary closure required", table_cell_l)],
    [Paragraph("Composite", table_cell),
     Paragraph("Ear helical root, earlobe", table_cell_l),
     Paragraph("May need flap or complex closure", table_cell_l)],
]
dst = Table(ds_data, colWidths=[3.5*cm, 7*cm, W - 10.5*cm])
dst.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  TEAL),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [GREY_LIGHT, WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.5, GREY_MED),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, GREY_MED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(dst)
story.append(Spacer(1, 0.4*cm))

# ─── Graft take phases ────────────────────────────────────────────────────────
story.append(section_banner("5. PHASES OF GRAFT 'TAKE' (REVASCULARISATION)"))
story.append(Spacer(1, 0.2*cm))

phase_data = [
    [Paragraph(h, table_header) for h in ["Phase", "Timing", "Description"]],
    [Paragraph("1. Imbibition", table_cell),
     Paragraph("0 - 48 hrs", table_cell),
     Paragraph("Graft absorbs plasmatic fluid from wound bed for passive nutrition", table_cell_l)],
    [Paragraph("2. Inosculation", table_cell),
     Paragraph("2 - 4 days", table_cell),
     Paragraph("Alignment and connection of graft and recipient vessels", table_cell_l)],
    [Paragraph("3. Neovascularisation", table_cell),
     Paragraph("4 - 7 days", table_cell),
     Paragraph("Ingrowth of new capillaries from the wound bed", table_cell_l)],
]
pt = Table(phase_data, colWidths=[3.5*cm, 3*cm, W - 6.5*cm])
pt.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  TEAL),
    ("ROWBACKGROUNDS",(0,1), (-1,-1), [GREY_LIGHT, WHITE]),
    ("BOX",           (0,0), (-1,-1), 0.5, GREY_MED),
    ("INNERGRID",     (0,0), (-1,-1), 0.3, GREY_MED),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(pt)
story.append(Spacer(1, 0.3*cm))

story.append(info_box(
    "<b>Causes of graft failure:</b> Shear forces disrupting graft-bed contact | "
    "Haematoma or seroma formation (lifts graft off bed) | "
    "Infection — especially beta-haemolytic Streptococcus, Staphylococcus, Pseudomonas | "
    "Avascular wound bed",
    bg=colors.HexColor("#FDECEA"), border=RED_SOFT))

story.append(Spacer(1, 0.4*cm))

# ─── Footer note ──────────────────────────────────────────────────────────────
story.append(hr(GREY_MED, 1))
story.append(Paragraph(
    "Sources: Bailey & Love's Short Practice of Surgery 28e (p.708) | "
    "Pfenninger & Fowler's Procedures for Primary Care 3e (p.257-259) | "
    "Dermatology 2-Volume Set 5e (Table 148.1) | "
    "Fischer's Mastery of Surgery 8e (p.7670) | "
    "Rockwood & Green's Fractures in Adults 10e (p.732)",
    S("Footer", fontName="Helvetica-Oblique", fontSize=7.5,
      textColor=colors.HexColor("#888888"), alignment=TA_CENTER, leading=11)))

# ── Build ─────────────────────────────────────────────────────────────────────
doc.build(story)
print(f"PDF saved to {OUTPUT}")