How Do Skin Grafts Work

What Can I Expect After My Skin Grafting

Knowing what to expect after skin grafting can help make your road to recovery as smooth as possible.

How long will it take to recover?

Most people stay in the recovery area for a few hours after skin grafting surgery. You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.

Some minor skin grafting surgeries are outpatient procedures, but many require a hospital stay. A 23-hour hospital observation period is common following skin grafting. A longer stay may be needed, depending on the extent of skin grafting, the reason for skin grafting, and its location. A skin graft on your leg or abdomen generally requires bed rest in the hospital as it heals.

You will still be drowsy from sedation or anesthesia, so you will need a friend or family member to drive you home and stay with you the first night.

You will have dressings on both the donor site and the graft site. The graft site usually requires a more specialized wound dressing to aid healing. This may include a VAC dressing, which is connected with a tube to a machine. The machine regulates the pressure around your wound.

Will I feel pain?

When should I call my doctor?

What Are The Different Types Of Skin Grafts

Skin grafts are classified as either split-thickness skin graft or full-thickness skin graft . STSG can be subclassified as thin , intermediate , or thick . STSG consists of the entire epidermis with a portion of the dermis, whereas FTSG includes the entire thickness of the skin, both epidermis and dermis.

Skin grafts also are classified by their donor site as autograft, self homograft, same species isograft, homograft between genetically identical people allograft, homograft between genetically different people and heterograft/xenograft, different species.

M. Kun, … S. Ramakrishna, in, 2009

Is There Any Other Advice I Should Know About Caring For My Skin Graft

Yes, the skin graft will be very sensitive to the sun. The graft may sunburn more readily or develop blotchy pigmentation. For the first year during strong sunshine, your graft should be protected. Keep it covered up or use total block cream that you can buy from your local chemist.

If you experience any problems immediately after your discharge from hospital, you can telephone Lynher Ward anytime on 01752 792274 for advice. If you experience any problems once you are under the care of the dressing clinic, please contact them on 01752 431024 .

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What Should I Expect After Skin Grafting

• Medicines may be given to prevent or treat pain, severe itching, or an infection.
• Bandages will cover the surgery area to hold the graft in place. Do not remove the bandage yourself. Your healthcare provider will arrange for the bandage to be removed or changed after a few days. Keep the bandage clean and dry.
• You may need to avoid certain activities , such as exercise or lifting heavy objects. You may also need to avoid activities that can irritate your wounds. Your surgeon will tell you which activities to avoid or limit.

What Is Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy makes it possible to deliver the concentrated oxygen needed for skin graft healing. Our skin cannot survive without oxygen, and the most effective way to provide skin cells with oxygen is through the blood. Hyperbaric oxygen therapy infuses the bloodstream with 100% concentrated oxygen.

Using a special hyperbaric chamber, HBOT helps oxygen dissolve directly into all of the bodys fluids so that it can thoroughly permeate areas where circulation has become reduced or blocked. This essential benefit of hyperbaric wound care stimulates and supports the bodys own healing process. When white blood cells receive enough oxygen, they can effectively kill bacteria, reduce swelling, and allow the rapid reproduction of new blood vessels.

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What Happens After Skin Graft Surgery

A skin graft usually involves two surgical sites . Your provider will monitor your health, look for signs of infection and make sure both sites are healing properly.

After surgery, you may need to stay in the hospital for up to two weeks. The length of stay depends on the type of skin graft surgery you get. Follow your providers instructions when you go home from the hospital. They may ask you to:

• Wear a cover or dressing over the wounds: Ask your provider how long you should keep the dressing in place, whether you can get it wet and how often you should change it. Your provider may recommend aloe vera cream or an antibiotic cream . Follow your providers instructions when using these creams.
• Keep the wound protected: Avoid physical activity that could damage the graft site during the healing process. Dont stretch the skin or do strenuous exercise for three to four weeks.
• Take medications to manage pain: To relieve pain after surgery, your provider may prescribe pain relief medication. You may also need other drugs to reduce inflammation or prevent infection.
• See your provider for follow-up visits: Your provider will want to see your skin and make sure youre healing properly. They may recommend a physical therapy program to improve the skins elasticity and prevent scar tissue from building up on the graft site.

When To Call The Doctor

• Pain gets worse or does not improve after taking pain relievers
• You have bleeding that won’t stop after 10 minutes with gentle, direct pressure
• Your dressing becomes loose
• Edges of the graft or flap start to come up
• You feel something bulging out of the graft or flap site

Also call your provider if you notice signs of an infection, such as:

• Increased drainage from the wound
• Drainage becoming thick, tan, green, or yellow, or smells bad
• Your temperature is above 100°F for more than 4 hours
• Red streaks appear that lead away from the wound

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What Is A Split

The Office of Dr. Vincent Hung

3 Minute Read:

Skin grafts are used to cover and repair the wounds left by skin cancer treatment when the surrounding skin is not healthy enough to heal by traditional wound healing.

Reconstruction of skin cancers can be difficult on the lower legs because of the tight skin, the presence of spider and varicose veins, and the necessity of that skin to stretch and expand when walking or exercising.

Since men and women often expose their lower legs, especially during the hot Southern California summers, reconstruction of skin cancers on the legs is essential.

How Does The Skin Graft Heal

Barring any complications, full-thickness grafts typically heal within three to four weeks. While your skin graft is healing, you should generally avoid strenuous activity for two or more weeks after surgery.

Unless there’s odor, drainage, or pain, your bandages should be left in place for five to seven days after the procedure. This is the amount of time it takes for the graft to connect with the surrounding blood supply.

When it’s time to remove the bandages, moisten them with sterile water to make sure the graft isnât lifted from the base. Initially, the color of the graft may seem reddish, but as it goes through the healing stages, the color will normalize. This may take a year or so. The final color may be slightly different from the surrounding skin.

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Who Performs Skin Grafting

The following specialists perform skin grafting:

• Plastic surgeons specialize in aesthetic and reconstructive surgery.

• General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions, including surgery of the breast, abdomen, and skin and soft tissue.

• Dermatologists specialize in the medical and surgical care of the skin, hair and nails.

• Facial plastic and reconstructive surgeons specialize in plastic and reconstructive surgery of the face. They initially train as plastic surgeons or otolaryngologists .

• Head and neck plastic surgeons specialize in correcting physical defects within the head and neck that can affect a person’s appearance and ability to function.

Hyperbaric Oxygen Therapy For Skin Graft Healing

Hyperbaric oxygen therapy can significantly increase the likelihood of graft survival and enhance skin graft outcomes.

Regular HBOT sessions effectively treat compromised skin grafts and flaps by restoring and strengthening the natural body processes needed to ensure skin-grafting success. HBOT also helps to increase the viability of any compromised tissue, reducing the need for additional grafting procedures.

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Caring For Skin Flaps And Grafts

You will need to care for the flap or graft site as well as the donor site. When you come home after surgery, you will have a dressing on your wounds. The dressing does several things, including:

• Protect your wound from germs and reduce the risk of infection
• Protect the area as it heals
• Soak up any fluids that leak from your wound

To care for the graft or flap site:

To care for the donor site:

• Leave the dressing in place. Keep it clean and dry.
• Your provider will remove the dressing in about 4 to 7 days, or give you instructions for how to remove it.
• After the dressing is removed, you may be able to leave the wound uncovered. However, if it is in an area that is covered by clothing, you will want to cover the site to protect it. Ask your provider what type of dressing to use.
• Do not apply any lotions or creams to the wound unless your provider tells you to. As the area heals, it may itch and scabs may form. Do not pick scabs or scratch the wound as it heals.

How Skin Grafts Are Held In Place

Surgical staples are used to secure the edges of a graft to healthy skin. The staples are put in and taken out with a tool that looks like a pliers. Once the edges have healed together and the graft is stable, the doctor removes the staples.

Sometimes the doctor sutures a graft in place with a needle and silk or nylon thread. When the graft is stable, the stitches are removed.

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What Are The Types Of Skin Grafts

• Full-thickness grafts are used for deep wounds, so all the layers of skin are taken for the graft. This type of graft is used when it is important to match your skin color, such as on your face. It may also be used when tightening of the skin should be avoided, such as on the fingers. The graft will be trimmed to the correct size and shape to fit the wound.
• Split-thickness grafts are used for shallow, large surface area wounds. The top 2 layers of skin are taken for the graft. This type of graft is also used when more blood and fluid are expected to drain from the wound. The graft is applied as a sheet if the wound is on your face, neck, or hand. It is meshed if it is not large enough to cover the wound.

Caring For The Bandaged Graft Site

• Do not touch the bandage. Leave it in place until you are told to remove or change it.

• Keep the bandage dry. Take a sponge bath to avoid getting your bandage wet, unless your healthcare provider tells you otherwise. Ask your provider about the best way to keep your bandage dry when bathing or showering. Ask your provider what to do if your bandage gets wet.

• Keep the bandaged area clean. Avoid getting dirt or sweat on it.

• If the bandage comes off or is damaged or very dirty, call your healthcare provider.

• If the tube on your vacuum bandage comes off, call your healthcare provider.

• As often as possible, elevate the graft site above the level of your heart. Do this when sitting or lying down. This helps reduce swelling and fluid buildup in the graft area.

• Keep the part of the body with the graft as still as possible. Avoid any movement that stretches or pulls the skin graft.

• If the graft bleeds, apply gentle but firm pressure to the graft site with a clean cloth or bandage for 10 minutes.

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What Happens After The Surgery

You will need to take things gently for the first two weeks to allow the graft to heal properly. The grafted area is quite fragile, so it is important not to rub or brush against the graft or the dressing, or put any pressure on the area. If it is anywhere other than on your leg, you can start walking as soon as you feel up to it. If it is on one or both of your legs, then we encourage limited mobility for usually for 2 days, or until the skin graft is secure enough for walking. This means you can transfer from bed to chair only and avoiding putting any weight through the grafted leg. The nursing staff will advise you when you can start to walk. If the grafted area is on your hand you may have a sling to keep your arm raised as much as possible.

What Will My Skin Graft Look Like

With any skin graft, scar formation is inevitable. The appearance of your skin graft will change considerably over the weeks and months to follow, so its initial appearance should not cause alarm. It can take up to 18 months for a scar to mature, usually leaving a pale, soft, flat and supple surface.

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What Is Skin Grafting

Skin grafting is a surgery that seeks to repair tissue damage by replacing it with healthy skin from another part of the body. Patients are given a local or general anesthetic, depending on the size of the graft and its location. The surgery itself takes anywhere from one to three hours. Usually, patients can heal over a series of days in their homes.

This procedure is typically done in a hospital and consists of:

• Removing damaged tissue
• Cleaning and preparing the site for the graft
• Selecting a donor site on the body where healthy tissue could be removed
• Harvesting the tissue to make a graft for the damaged area
• A few small slits may be cut into the graft to prevent fluid collection
• Surgically attaching the graft to allow it to heal with staples, stitches, or glue
• Covering the area with a sterile dressing and/or a splint to protect the graft

There are two primary types of skin grafts:

• A partial or split-thickness skin graft is where a very thin layer of skin is shaved off the donation site
• A full-thickness skin graft takes the top later along with the layers below

Both of these are usually taken from an area of the body that easily heals, such as the thighs, calves, or buttocks. These areas are also easily hidden under clothing, so any lasting scars go generally unseen.

Full Thickness Skin Graft

This is where the full thickness of skin are removed and the area is stitched closed.

Sites often used include the neck, behind the ear, the upper arm and groin.

Because this type of skin graft is thicker, picking up a new blood supply can be more difficult, so any dressing will be left in place for 5 to 7 days before being removed by the surgical team.

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How Does Skin Grafting Work

• What is skin grafting?
• Why would you need a skin graft?
• What is recovery like after skin grafting?
• What are the best questions to ask my doctor about skin grafting?

A skin graft takes healthy skin from one part of the body thats normally covered by clothing and uses it to cover a wound or burn, holding it in place with a dressing and stitches. This procedure is very helpful for patients who need cosmetic or reconstructive surgery to repair skin loss or damaged skin.

Where Do Providers Get Healthy Skin For A Skin Graft

Most often, providers use healthy skin from a persons own body. They call this skin graft procedure an autograft.

Sometimes, there isnt enough healthy skin on a persons body to use for the procedure. If this happens, a provider may take the skin from a cadaver .

Providers can also use skin from an animal, most commonly a pig . 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.

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Healing And Complications Of Skin Grafts

Skin cannot survive without oxygen. The best way to infuse skin cells with oxygen and other nutrients is through the blood. Healthy, living skin is full of tiny blood vessels that channel the body’s blood supply to grow new skin cells and sustain older ones.

For a skin graft to heal, it must grow and activate new blood vessels. In a successful graft, this regeneration process begins as quickly as 36 hours after surgery .

Because oxygen is so important to the healing process, some doctors prescribe hyperbaric oxygentherapy. Perhaps you’ve heard of a hyperbaric chamber. It looks like a long, glass-walled tube surrounding a raised bed. Inside a hyperbaric chamber, the patient is exposed to a 100 percent oxygen environment at twice the normal atmospheric pressure. These intense blasts of pure oxygen can speed the healing process of skin grafts.

Another healing technique is something called vacuum-assisted closure . In this post-operative procedure, the grafted skin is dressed with a porous bandage and attached to a tube that connects to a vacuum source. The vacuum helps draw out interstitial fluids and encourage blood flow to the graft. All potentially infectious fluids are sucked out of the wound for easy disposal. Some surgeons are so impressed with the technique that they leave the VAC tube attached for up to seven days after surgery without even changing the dressing .