Skin Graft Overview
Skin grafting is a surgical procedure that involves removing skin from one area of the body and moving it, or transplanting it, to a different area of the body. This surgery may be done if a part of your body has lost its protective covering of skin due to burns, injury, disease, infection or other illness. Within a few days, the grafted skin begins to develop blood vessels and connects to the skin around it. The recovery time after this surgery varies depending on your overall health, the size of the graft and the technique your provider used. Most skin graft procedures are successful the first time.
When a patient’s own skin is used for a skin graft, it’s called an Autograft. Autografts are the best option for long-term treatment because the body will ultimately reject any foreign skin. However, sometimes there isn’t enough healthy skin on a person’s body to use for the procedure. If this happens, a provider may take the skin from a cadaver (allograft).
Providers can also use skin from an animal, most commonly a pig (xenograft). Allograft and xenograft skin grafts are usually temporary. They cover the damaged skin until the wound heals, or the person grows enough healthy skin to use for a permanent skin graft.
Dr. Michael K. Kim may recommend a skin graft if you have damaged or missing skin that cannot heal on its own. Skin grafts help people who have skin loss due to:
- Burns;
- Infection;
- Surgery to remove skin cancer (such as Mohs surgery);
- Skin ulcers and bedsores (pressure injury);
- Slow-healing wounds or very large wounds.
2 Main Types of Skin Grafts
- Split-Thickness Skin Grafts
A split-thickness graft involves removing the top layer of the skin — the epidermis — and only a portion of the deeper layer of the skin, called the dermis. These layers are taken from the donor site, which is the area where healthy skin is located. Split-Thickness Skin Grafts are usually harvested from the front or outer thigh, abdomen, buttocks, or back.
A split-thickness skin graft is further divided based on its dermal thickness:
- Thin – 0.008- to 0.012-mm
- Medium – 0.012- to 0.018-mm
- Thick – 0.018- to 0.030-mm
Split-thickness grafts are used to cover large areas. These grafts tend to be fragile and typically have a shiny or smooth appearance. They may also appear paler than the adjoining skin. Split-Thickness Grafts don’t grow as readily as ungrafted skin, so children who get them may need additional grafts as they grow older.
- Full-Thickness Skin Grafts
A full-thickness graft involves removing all of the epidermis and dermis from the donor site. These are usually taken from the abdomen, groin, forearm, or area above the clavicle (collarbone). They tend to be smaller pieces of skin, as the donor site from where it’s harvested is usually pulled together and closed in a straight-line incision with stitches or staples.
Full-thickness grafts are generally used for small wounds on highly visible parts of the body, such as the face. Unlike split-thickness grafts, full-thickness grafts blend in well with the skin around them and tend to have a better cosmetic outcome, however, because the transplantation site is “deeper,” it does usually require more healing time.
Composite Grafts
During this procedure, providers transplant skin as well as cartilage or other soft tissues. Composite grafts can repair damage to the nose, fingertips and ears.
Skin Graft Recovery
After surgery, you may need to stay in the hospital for up to two weeks. The length of stay, your follow-up protocol and the time before returning to normal activities, depend on the type of skin graft surgery received. You may be asked to:
- Wear a cover or dressing over the wounds: Ask Dr. Michael K. Kim how long you should keep the dressing in place, whether you can get it wet and how often you should change it. Dr. Kim may also recommend aloe vera cream or an antibiotic cream (such as bacitracin). Follow your provider’s instructions when using these creams.
- Keep the wound protected: Avoid physical activity that could damage the graft site during the healing process. Don’t stretch the skin or do strenuous exercise for three to four weeks.
- Take medications to manage pain: To relieve pain after surgery, Dr. Kim may prescribe pain relief medication. You may also need other drugs to reduce inflammation or prevent infection.
- Schedule Follow-Up Appointments with Dr. Kim. He will want to see your skin and make sure you’re healing properly and may recommend a physical therapy (PT) program to improve the skin’s elasticity and prevent scar tissue from building up on the graft site.
