Skin Graft Overview
Skin grafting refers to the process of replacing or restoring areas of injured skin using healthy donor tissue. Skin grafts are primarily used when the skin injury is extensive, such as in the case of large burns, wounds, or ulcers.
There are several types of skin grafts, differentiated by the type of tissue used in the graft:
• Autograft – Your own skin (from a donor site on your body) is used. This is the most common kind of skin graft.
When your body cannot provide sufficient skin for the graft, tissue from other sources will be used and may include:
• Allograft – Skin from another human, often a cadaver
• Xenograft – Skin from an animal source
• Synthetic tissue
There are three main techniques used in skin grafting:
• Split-thickness graft
• Full-thickness graft
• Composite graft
The type of skin graft you receive and the surgical technique utilized will depend on your individual condition, as determined in your pre-operative consultation.
Dr. Vallecillos will provide you with a full pre-operative care plan, which may include cessation of blood-thinning medications (such as aspirin) and smoking for at least two weeks before the surgery. If you are over the age of 45, you may be required to obtain medical clearance through an independent physician prior to receiving a skin graft.Dr. Vallecillos may also require that you undergo a mammogram before the procedure, as well as after healing is complete. Typically, the breasts are also photographed and measured before and after the operation, to qualify results.
Anesthesia for a skin graft will vary depending on the size of the area to be treated and the type of graft being used. Local anesthesia, local anesthesia with an intravenous sedater, or general anesthesia will be administered.
- For most skin graft procedures, Dr. Vallecillos will utilize one of the following surgical techniques:
In this method, a tool is used to remove skin tissue down to the middle of the dermis from the donor site. The tissue may then be meshed, which refers to the process of placing holes in the tissue to allow it to stretch over a much larger area.
A full-thickness graft refers to the excision of an entire area of skin. This process requires stitches at the donor site and requires that the grafting site have high vascularization but allows for better healing and a more cosmetic result. Full-thickness grafts are often used for injuries on the face.
This method refers to a graft that is comprised of a combination of skin and other tissue such as cartilage or fat, and is used for three-dimensional grafts such as on the nose.
The grafted tissue is secured to the site and the wound is dressed. Pressure bandages or suction devices may be used to control drainage and promote healing during the post-operative period. If the graft is successful, new blood vessels begin to form in the grafted area within several days and new cells will begin to grow from the graft onto the damaged area.
Skin Graft FAQ
Who is a candidate for a skin graft?
You should consider a skin graft if you require skin repair for damage sustained due to an injury, such as a burn. Skin grafts are usually performed when the area of injury is extensive and other methods such as tissue expansion are not viable.
What is the recovery time for a skin graft?
Post-operative care is very important for proper healing of a skin graft. Patients should ensure that the surgical site undergoes no physical trauma, is kept properly bandaged, and is not exposed to the sun during this period. Some tissue necrosis (or cell death) may occur and should be closely monitored by your surgeon at each follow-up visit. Recovery time will vary for each patient.
Are there risks or side effects with a skin graft?
As with any surgery, there is a risk of bleeding and infection. Skin grafts can be particularly fragile, and risks include tissue necrosis and contracture (tightening of the skin; can restrict mobility). If donor tissue is used, there is also a risk of graft-versus-host disease. Dr. Vallecillos will discuss all risks beforehand.
How long do the results last?
Although skin grafts can drastically improve the appearance of injured skin, the grafted site may differ from the surrounding skin in color and/or texture. It is important to have realistic goals, and realize that skin grafting may require several procedures and a prolonged recovery. That being said, if a skin graft is successful, the results should be permanent.