Skin Graft

Definition

A skin graft surgery is the removal of healthy skin from one area of the body to be used in another area. It is done to replace skin that has been severely damaged. The skin grafts are most often taken from the side of the thigh, buttocks, below the collarbone, near the ear, or the upper arm.

When possible the skin graft will be taken from your own body. This type of graft is called an autograft. However, this is not always possible. Other sources of graft include:

  • Allograft—skin taken from another human source, such as a cadaver
  • Xenograft—skin taken from an animal source
  • Synthetic (manmade) tissue

These other sources are only meant for temporary use. They can help protect the area until your own skin grows back.

Reasons for Procedure    TOP

Skin grafts are done to:

  • Promote healing of:
  • Restore skin removed during surgery. Examples include: treatment for skin cancer, tumor removal, or after serious skin infection.

Successful transplanted skin will attach and grow in the new area. The appearance of the skin will vary. The type of skin graft used and the area it was needed will play a role in the cosmetic outcome.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Graft failure
  • Infection at either the donor or recipient site
  • Poor healing
  • Increased or decreased sensation at the recipient site
  • Hair may not grow on recipient site
  • Graft tissue contracts, interfering with limb movement
  • Scarring
  • A collection of blood outside of a vessel, known as a hematoma
  • Differences in skin coloration

Factors that may increase the risk of complications include:

  • Age—newborns, infants, or adults aged 60 years and older
  • Smoking
  • Diabetes
  • Poor overall health
  • Use of certain medications

What to Expect    TOP

Prior to Procedure

The wound will be cleaned.

Anesthesia

Depending on the surgery, you may receive:

  • Local anesthesia—the immediate area is numbed
  • Regional anesthesia—a large area of your body will be numbed, but you will be awake
  • General anesthesia—you will be asleep

Description of Procedure    TOP

The wound will be measured. A pattern of the wound will be traced and outlined over the donor site. The donor tissue will be removed with a scalpel or special harvesting machine.

There are three main types of skin graft techniques. Your doctor will talk about the benefits and risks of options for you.

  1. Split-thickness graft —The doctor will remove the top and middle layer of skin. This type of graft allows the area to heal more quickly. There may be color differences in this type of graft. Multiple holes are placed in the graft. This can give it a mesh appearance. The mesh allows fluid to leak out from the tissue under the graft. The meshed skin will be able to spread out over a much larger area of injury.
  2. Full-thickness graft —The doctor will remove and transfer of the entire thickness of the skin. Stitches are often needed at the donor site. The final outcome is usually better. This method is often used for areas where cosmetic outcome is important, such as the face. The use of full-thickness skin grafts is limited by size and donation area. It would be hard to close a large donation area with stitches.
  3. Composite grafts —The doctor will remove a combination of skin and fat, skin and cartilage, or the middle layer of skin and fat. It is used in areas that need complex structure, such as the nose. These types of grafts are often removed from the ear.

The graft will be placed on the damaged site. It will be attached with stitches or staples.

A pressure bandage will be applied over the area. A wound vacuum-assisted closure (VAC) may be placed for the first 3-5 days. This device has suction and helps to control drainage from the wound. New blood vessels begin to grow into the wound within the first 48 hours. New cells will grow from the graft. Over time the new growth will cover the damaged area with new skin.

Skin Graft

EQ00033
A split-thickness graft is fastened to the damaged site.
Copyright © Nucleus Medical Media, Inc.

How Long Will It Take?    TOP

This varies according to your specific needs. The size of the graft and injury will play a role in the length of the surgery.

How Much Will It Hurt?    TOP

Removing skin grafts can be painful. Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medicine.

Average Hospital Stay    TOP

The hospital stay will depend on your needs. For example, a burn or accident may need a longer stay.

Postoperative Care    TOP

When you get home, you will need to:

  • Keep the areas clean and dry.
  • Avoid all trauma to the sites.
  • Avoid periods of prolonged sunlight in area of new skin.
  • Check the site for healing and good blood flow. There should be a healthy pink color in the skin.
  • Follow instructions for bandaging. This will help to support the area while it heals. It will also help to prevent intense tightening of the skin called contractures.

Call Your Doctor    TOP

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the wounds
  • Headache, muscle aches, lightheadedness, or general ill feeling
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Society for Dermatologic Surgery
https://www.asds.net
DermNet New Zealand
https://www.dermnetnz.org

CANADIAN RESOURCES:

Canadian Dermatology Association
http://dermatology.ca
Canadian Society of Plastic Surgeons
http://plasticsurgery.ca

References:

Skin grafting. DermNet New Zealand website. Available at: https://www.dermnetnz.org/topics/skin-grafting. Accessed September 5, 2017.
Skin grafting and flap surgery. University of Miami Health System website. Available at:
...(Click grey area to select URL)
Accessed September 5, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 9/30/2013

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.