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.
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.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Infection at either the donor or recipient site
Increased or decreased sensation at the recipient site
Hair may not grow on recipient site
Graft tissue contracts, interfering with limb movement
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
Poor overall health
Use of certain medications
What to Expect
Prior to Procedure
The wound will be cleaned.
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
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.
—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.
—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.
—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.
A split-thickness graft is fastened to the damaged site.
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