SKIN GRAFTS

A skin graft is surgical procedure in which a piece of skin from one area of the patient’s body is transplanted to another area of the body. Skin from another person or animal may be used as temporary cover for large burn areas to decease fluid loss. The skin is taken from a donor site, which has healthy skin and implanted at the damaged recipient site. Skin graft and flaps are more serious than other scar revision surgeries such as dermabrasion. They are usually performed in a hospital under general anesthesia. The treated area depending on the size of the area and severity of the injury will determine the amount of time needed for healing. This time may be 6 weeks or a few months. Within 36 hours of the surgery new blood vessels will begin to grow from the recipient area into the transplanted skin. Most grafts are successful, but some may require additional surgery if the do not heal properly.

There are several types of skin grafts: pinch, split-thickness, full-thickness, and pedicle grafts.

• Pinch grafts – Quarter inch pieces of skin are placed on the donor site. These small pieces of skin will then grow to cover injured sites. These will grow even in areas of poor blood supply and resist infection.
• Split-thickness grafts – consists of sheets of superficial and some deep layers of skin. The grafts removed from the donor sites may be up to 4 inches wide and 10 to 12 inches long. The grafts are then placed at the recipient site. Once the graft is in place, the area may be covered with a compression dressing or the area maybe left exposed. Split-thickness grafts are used for non-weight-bearing parts of the body.
• Full-thickness grafts – are used for weight-bearing portions of the body and friction prone areas such as, feet and joints. A full-thickness graft contains all of the layers of the skin including blood vessels. The blood vessels will begin growing from the recipient area into the transplanted skin with in 36 hours.
• Pedicle grafts – with a pedicle graft a portion of the skin used from the donor site will remain attached to the donor area and the remainder is attached to the recipient site. The blood supply remains intact at the donor location and is not cut loose until the new blood supply has completely developed. This procedure is more likely to be used for hands, face or neck areas of the body.

The success of a skin graft can be determined within 72 hours of the surgery. If a graft survives the first 72 hours without an infection or trauma the body in most cases will not reject the graft. Before the surgery, the recipient and donor sites must be free of infection and have a stable blood supply. Following the procedure moving and stretching the recipient site must be avoided. Dressings need to be sterile and antibiotics may be prescribed to avoid infection.