Photo from sciencephoto.com
Skin grafting is a surgical procedure. During this process, doctors take healthy skin from one place of the body and transplant (transfer) it to cover damaged or missing skin Within a few days, the grafted skin develops blood vessels and connects to the surrounding skin.
Skin transplant surgery is used to heal persons who have damaged skin due to burns, traumas, wounds, sickness, or infection. If you've had skin cancer surgery, your doctor may propose a skin graft to replace the missing skin.
The recuperation period after this surgery varies based on your overall health, the amount of the graft and the approach your physician utilized. The majority of skin graft surgeries are effective the first time around. Sometimes, the transplanted skin doesn’t mend effectively or “take” to the surrounding skin. If this occurs, you may require another skin graft.
WHAT ARE THE TYPES OF SKIN GRAFT SURGERY?
The following are the various methods of skin graft surgery
- Split-thickness skin graft (STSG): During this surgery, your provider removes the top layer of skin (epidermis) and only part of the second layer (dermis) (dermis). STSG is typically used by providers to cover significant areas of damaged or missing skin. They usually remove healthy skin from the thigh, bottom, tummy, or back. The area from which the skin was removed (donor skin) usually heals on its own in 1-2 weeks.
- Full-thickness skin graft (FTSG): During a FTSG, your provider will remove and transplant the top layer of skin as well as the entire second layer. Because the transplanted skin is thicker, FTSG treatments take more healing time than STSG procedures. Providers may choose FTSG for an area of the body that you don’t generally cover up with clothing, such as the face. For FTSG, doctors frequently remove healthy skin from the groin, arm, or collarbone area and then immediately close the donor incision.
- Composite graft: Skin, cartilage, and other soft tissues are transplanted during this treatment. Damage to the nose, fingertips, and ears can be repaired with composite grafts.
WHERE DO DOCTORS GET HEALTHY SKIN FOR SKIN GRAFTS?
Most doctors use healthy skin from the patient's own body. This skin graft method is known as an autograft.
Sometimes a person's body does not have enough healthy skin to use for the surgery. If this occurs, a provider may extract skin from a cadaver (allograft).
Providers can also utilize animal skin, most typically pig skin (xenograft). Skin grafts from allografts and xenografts are typically only temporary. They cover the injured skin while the wound heals or until the person grows enough healthy skin for a permanent skin graft.
WHAT IS THE PURPOSE OF A SKIN GRAFT?
If you have damaged or missing skin that cannot heal on its own, your provider may offer a skin graft. Skin grafts assist persons who have lost skin due to:
- Burns.
- Infection.
- Skin cancer removal surgery (such as Mohs surgery).
- Bedsores and skin ulcers (pressure injury).
- Wounds that heal slowly or that are quite huge.
WHAT HAPPENS PRIOR TO A SKIN GRAFT SURGERY?
Before skin transplant surgery, your physician may ask you to stop taking some drugs (such as blood thinners). If you smoke, you should stop a few weeks before your surgery. Smokers are more prone to experience difficulties following a skin graft. It is more difficult for your skin to heal after surgery if you smoke.
Before surgery, you will meet with your provider to plan the procedure and identify the location of the donor site. The donor site is the healthy skin that will be removed by your provider. The healthy skin will be transplanted to the graft location (the damaged or missing skin). Your provider will look for healthy skin that matches the tone and texture of the graft site when deciding which healthy skin to transplant.
WHAT HAPPENS DURING A SKIN GRAFT SURGERY?
In a hospital, you will have skin graft surgery. Your procedure will most likely be performed under general anesthesia (completely asleep), while minor grafts can be performed under local anaesthetic. The surgeon will create incisions (cuts) in the donor site and extract healthy skin. Depending on the technique used by your provider, healthy skin from the:
- The abdomen (belly).
- Back or chest.
- Bottom or groin region
- Clavicle region (collarbone).
- Forearm.
- Inner thigh, outer thigh or hip.
Before transplanting the healthy skin, your physician may make numerous tiny crisscrossed cuts or poke small holes in it. This approach is known as meshing by providers. Healthy skin may resemble a fishnet. This procedure allows your physician to stretch the skin over a bigger area. It also aids in the healing of the surgical site.
Your provider covers the injured or missing skin with healthy skin. They sew or staple the skin in place and apply a dressing to the area. After surgery, the donor and graft sites will recover. However, the graft site will most likely take longer to heal.
WHAT HAPPENS AFTER A SKIN GRAFT SURGERY?
A skin graft normally requires two surgical sites (the donor site and the graft site). Your provider will keep an eye on your health, search for signs of infection, and ensure that both sites heal properly.
You may need to stay in the hospital for up to two weeks following surgery. The length of your stay is determined by the type of skin graft operation you receive. When you leave the hospital, follow your provider's recommendations. They may request that you:
Cover the wounds with a bandage or dressing: Inquire with your provider about how long you should leave the dressing in place, whether it can become wet, and how frequently you should replace it. Your doctor may advise you to use aloe vera cream or antibiotic cream (such as bacitracin). When using these creams, follow the directions provided by your supplier.
Protect the wound: Avoid physical activity that could harm the graft site as it heals. Don’t stretch the skin or conduct intense exercise for three to four weeks.
Take pain medications: Your doctor may prescribe pain relievers to help you recover after surgery. Other medications may be required to decrease inflammation or prevent infection.
Follow-up appointments should be made with your provider: Your physician will want to examine your skin to ensure that you are healing appropriately. They may suggest a physical therapy (PT) regimen to increase skin suppleness and prevent scar tissue from forming at the transplant location.
WHAT ARE THE BENEFITS OF A SKIN GRAFT?
Skin grafts can replace missing skin, enhance the look of injured skin and restore function. This operation is an excellent treatment for skin loss caused by a variety of disorders.
WHAT ARE THE RISKS ASSOCIATED WITH SKIN GRAFT SURGERY?
The majority of skin grafts are effective. However, sometimes the transplanted skin may not adapt to the new environment. If the transplanted skin does not heal properly, you may require another skin graft. An failed skin graft frequently comes from:
- Blood or pus accumulating behind the grafted skin.
- Infection.
- Damage to the graft site (for example, moving the newly transplanted skin too much while it heals).
- Blood circulation issues that cause the wound to heal too slowly (this happens more often in people who smoke).
Other risks associated with skin graft surgery include
- Bleeding.
- Contracture, which occurs when the grafted skin shrinks and draws in at the edges.
- Skin that is discolored, spotty, or uneven.
- Skin sensory loss or increased pain sensitivity.
- Pain that persists after the wound has healed (chronic pain).
- Scar tissue developing around the transplant site.
WHEN MAY I RESUME MY NORMAL ACTIVITIES FOLLOWING A SKIN GRAFT?
The length of recovery following skin graft surgery is determined by your overall health, the size and kind of skin graft, and the location of the graft site Your doctor may advise you to wait several weeks before exercising, driving, or carrying anything heavy. Inquire with your provider about when you will be able to resume your favorite activities.
WHEN SHOULD I CONSULT MY DOCTOR ABOUT SKIN GRAFT SURGERY?
If you develop any of the following symptoms, contact your provider right away:
- Bleeding or pus draining from incisions.
- Severe pain or pain that does not improve with medicine
- Infection symptoms, such as fever
Children who have had skin graft surgery may require additional procedures as they develop. The transplanted skin does not always develop and stretch with the child's skin. Inquire with your provider about the necessity for future procedures if your child has had a skin graft.
CONCLUSION
Skin grafting is used by healthcare experts to help major wounds heal, restore missing skin, and improve the appearance of injured skin. The majority of skin graft procedures are successful. However, sometimes the donor skin does not adhere to the graft location. If this occurs, you may need another skin graft. Follow your provider's post-surgery instructions attentively to reduce your risk of problems. Inform your provider about any drugs you're taking before surgery. If you smoke, speak with your provider about stopping before surgery.