skin graft
What Is a Skin Graft?
A skin graft is a surgical procedure that involves
removing skin from one part of your body (the donor
site) and moving it, or transplanting it, to a different
part. This surgery may be done if part of your body
has lost its protective covering of skin due to injury or
illness.
Skin grafts are performed in a hospital. Most skin
grafts are performed using general anesthesia, which
means that you will sleep painlessly throughout the
procedure.
Reasons for Skin Grafts
A skin graft is placed over an area of the body where
the skin has been lost. Some common reasons for
skin grafts include:
skin infections
deep burns
large, open wounds
bed sores or other ulcers on the skin that don’t heal
well
Types of Skin Grafts
There are two basic types of skin grafts: split-level
thickness and full thickness.
Split-Level Thickness Grafts
A split-level thickness graft involves removing only the
top two levels of the skin—the epidermis and the
dermis—from the donor site. These grafts are used to
cover large areas. Split-level grafts tend to be fragile
and have a shiny or smooth appearance. They may
also appear paler than the adjoining skin.
Full-Thickness Grafts
A full thickness graft involves removing the muscles
and blood vessels as well as the top layers of skin
from the donor site. Full-thickness grafts are generally
used for small wounds on a highly visible part of the
body, such as the face. Unlike split-level thickness
grafts, they blend in well with the skin around them
and usually grow with the individual.
Skin Graft Preparation
You may need to stop taking certain medications,
such as aspirin, that interfere with the blood’s ability to
form clots.
You should minimize stair climbing immediately after
the surgery and plan to have someone to stay with
you to help take care of you during your first few days
at home.
Your doctor will tell you not to eat or drink anything
after midnight on the day of the surgery.
Skin Graft Procedure
You will arrive at the hospital on the morning of the
surgery. A nurse or a technician will help you get
ready for the operation by giving you a hospital gown
to wear in place of street clothes and starting an IV in
your hand, arm, or wrist. The IV allows your doctors to
give you medicine and fluids during and after the
surgery.
When it is time for your operation, you will be taken
into the operating room. Once you are in the
operating room, a doctor will inject a medicine into
your IV line. The medicine, called general anesthetic,
will make you fall asleep and stay asleep throughout
the surgery so that you don’t feel any pain.
The surgeon will begin the operation by removing skin
from the donor site. If you are getting a split-level
thickness graft, the skin will be removed from an area
of your body that is usually hidden by clothes, such as
your hip or the inside of your thigh. If you are getting a
full-thickness graft, the preferred donor sites are the
abdominal wall or the chest wall.
Once the skin is removed from the donor site, the
surgeon carefully places it over the transplant area
and fixes it in place with a surgical dressing, staples,
or stitches. He or she will also cover the donor area
with a dressing that won’t stick to the wound.
Aftercare for a Skin Graft
You will wake up in the recovery room. The staff will
watch you closely after surgery, monitoring your vital
signs and giving you medications to manage pain.
When the staff is sure you are stable, you will be
taken to a hospital room to continue your recovery.
The graft should start developing blood vessels to
connect it with the skin around it within 36 hours. If
these blood vessels do not begin to form, it could be a
sign that your body is rejecting the graft. You may
hear doctors say that the graft “hasn’t taken.” If the
graft doesn’t take, you may require another operation
and a new graft.
Your doctor will probably discharge you with a
prescription for painkillers and instructions about how
to care for the graft site and the donor site to avoid
infection.
Avoid activities that stretch or pull the graft site for at
least three to four weeks. The donor site will heal
within two to three weeks. Your doctor will tell you
when it is safe to resume your normal activities.