Skin grafting is a surgical procedure in which the skin is removed from one part of the body and moved, or transplanted, into another part of the body. This procedure can be performed if a part of your body has lost its protective skin coating due to burns, injuries or illnesses. (1)
Skin grafts are conducted in the hospital. Most skin grafts are done using a general anesthetic, which means that you will be asleep throughout the procedure and will not experience any pain. (2)
Why are skin grafts done?
A skin graft is located on a part of the body where the skin has been lost. The main reasons for skin grafting include the following:
- large, and open wounds
- bed sores
- skin infections
- deep burns
- Ulcers on the skin that did not heal properly.
- skin cancer surgical procedure.
Types of skin grafts
There are two primary types of skin grafts:
- full-thickness grafts
A split-thickness graft consists of removing the top layer of the skin from the epidermis and a portion of the deeper layer of the skin, called the dermis. These coats are collected from the donor site, which is the area of healthy skin. Skin grafts are typically collected on the front or outside of the thigh, abdomen, buttocks or back.
Split-thickness grafts are used for covering large body area. They tend to be fragile and usually look shiny or smooth. They can also be seen paler than the adjoining skin. Split-thickness grafts do not grow as easily as unborn skin, so children who receive them may need extra grafts as they age.
A full-thickness graft is the removal of the entire skin and dermis from the donor site. They are generally collected in the abdomen, groin, forearm or over the clavicle (clavicle). They are more likely to be smaller pieces of skin, as the donor site of the place where it is harvested is generally collected and closed in a straight line incision with dots or staples.
Full-thickness grafts are usually used for small injuries on high-visibility body parts, such as the face. Unlike split-thickness grafts, full-thickness grafts blend well with the skin that surrounds them and tend to have better cosmetic results.
How to prepare for a skin graft
Your physician will probably plan your skin transplant several weeks ahead, so you will have time to plan the surgery. Inform your physician in advance of any prescription or non-prescription drugs you are taking. Some medications, like aspirin, can affect the ability of blood to clot. Your physician may ask you to change your dosage or discontinue these medications prior to surgery.
In addition, smoking or tobacco products will interfere with your ability to cure a skin transplant, so your doctor will probably ask you to quit smoking before your surgery.
Your physician will also tell you not to eat or drink anything after midnight on the day of surgery. This is to keep you from vomiting and choking during the operation if the anesthetic makes you nauseous.
You should also plan to have a family member or friend come and take you home after the surgery. General anaesthesia can make you drowsy after surgery, so you should not drive until the effects have completely dissipated.
It’s also a great idea to have someone stay with you during the first few days after the operation. You may require assistance in completing certain tasks and moving around the house.
Skin graft procedure
The surgery will be started by removing the skin from the donor site. If you obtain a split-thickness graft, the skin will be removed from a part of your body that is usually hidden by clothing, like your hip and the outside of your thigh. If you receive a full-thickness transplant, the preferred donor sites are the abdomen, groin, forearm or area over the clavicle (clavicle). (1)
After removing the skin from the donor site, the surgeon carefully places it on the graft area and secures it with a surgical dressing, staples or sutures. If it’s a split-thickness graft, it may be “meshed.” The physician may drill several holes into the transplant to stretch the piece of skin so that it can harvest less skin from your donor site. This also allows the liquid to drain from the underside of the skin transplant. The removal of fluid below the graft can cause it to fail. In the long term, the mesh can result in the skin grafting taking on the appearance of a “fish net”.
The physician also covers the donor area with a bandage that will cover the injury without sticking to it.
Aftercare for a skin graft
Hospital staff will monitor you closely after your procedure, monitor your vital signs and give you medication for pain management. (1)
In case you had a split-thickness graft, Your physician may want you to stay in the hospital for a few days to ensure that the transplant and donor site are all right.
The transplant is expected to begin developing blood vessels and connecting to the surrounding skin within 36 hours. If these blood vessels do not start forming soon after the operation, this may be a sign that your body rejects the transplant.
You can hear your physician saying that the transplant “didn’t take.” This can occur for a number of reasons, including infection, collection of fluid or blood under the transplant, or excessive movement of the transplant on the wound. This can also occur if you smoke or if the blood flow to the transplant area is low. You may need additional surgery and a new transplant if the first transplant is not performed.
When you’re discharged from the hospital, your physician will prescribe pain relievers. They will also tell you how to take care of the transplant site and donor site to avoid infection.
The donor site will recover within one to two weeks, but the transplant site will take a little longer to recover. For at least 3-4 weeks after the operation, you should avoid any activity that could stretch or hurt the transplant site. Your physician will let you know when it is safe to return to your regular activities.