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Skin graft
Definition
A skin graft is a patch of skin that is surgically removed from one area of the body and transplanted to another area.
Alternative Names
Skin transplant; Skin autograftingDescription
While you are sleepy (sedated) or deep asleep and pain-free (general anesthesia), healthy skin is taken from elsewhere on your body using a skin-cutting instrument (dermatome). This is called a split-thickness skin graft. It contains a portion of the top layer of skin (epidermis) and the layer under the epidermis (dermis).
The donor site can be taken from any area of the body -- usually an area that is hidden by clothes, such as the buttock or inner thigh. Which area is selected should be based on the visibility of the donor skin and color match. The graft is carefully spread on the bare area to be covered. It is held in place either by gentle pressure from a well-padded dressing, by staples, or by a few small stitches. The raw donor area is covered with a sterile dressing for 3-5 days to protect it from infection.
People with greater tissue loss may need a full-thickness skin graft, which includes the entire thickness of the skin. In this more complicated procedure, a flap of skin with its muscles and blood supply is transplanted to the area to be grafted. Common donor sites include skin and muscle flaps from the back or abdominal wall.
Indications
Skin grafts may be recommended for:
- Extensive wounds
- Burns
- Surgeries that need skin grafts to heal
- Areas where there has been infection with extensive skin loss
- Cosmetic reasons or reconstructive surgeries
Full-thickness grafts are used when a lot of tissue is lost. This can happen, for example, with open fractures of the lower leg.
Risks
Risks for any anesthesia are:
- Reactions to medications
- Problems breathing
- Bleeding
- Infection
- Loss of grafted skin
Expectations after surgery
New blood vessels begin growing from the recipient area into the transplanted skin within 36 hours. Most skin grafts are successful, but in some cases they don't heal well and need another graft. The graft should be checked for good blood flow (circulation).
Convalescence
The recovery from surgery is usually quick after split-thickness skin grafting, except in cases of major burns. The skin graft must be protected from trauma or major stretching for 2-3 weeks. Depending on the location of the graft, you may need to wear a dressing for 1-2 weeks. Avoid exercise that might stretch or injure the graft for 3-4 weeks. Some people need physical therapy after skin grafting.
Full-thickness grafts need a longer period of recovery. Most people with these grafts need to stay in the hospital for 1-2 weeks.
Review Date:5/3/2007
Reviewed By:Robert A. Cowles, M.D., Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.
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