Skin grafting: Purpose and procedure

Skin grafting is a surgery that involves removing the skin from one body area and moving or transplanting it to another area of the body that needs them. This surgery can be performed when part of your body loses its protective skin due to burns, injuries or illnesses.

Skin grafting is a surgery that involves removing the skin from one area of the body and moving or transplanting it to another area of the body that needs them. This surgery can be performed when part of your body loses its protective skin due to burns, injuries or illnesses.

Skin grafts are performed in the hospital. When skin grafting is mostly done by body anesthesia, which means that you will sleep throughout the process and not feel pain.

Skin grafts are implanted on a lost area of the body. Common reasons for skin grafting include:

• Skin infections.
• Deep burns.
• Large open wounds.
• Ulcers caused by lying long in bed or other ulcers on the skin have not completely healed.
• Skin cancer surgery.
• Skin grafts for scars.

There are two basic types of skin grafts: Thin skin grafting and full thickness grafting.

3.1. Split thickness pairing

This method of grafting according to the thickness of the skin layer individually, consists in removing the top layer of the skin (epidermis) as well as part of the deeper layer of the skin, which is called the dermis. These layers are taken from the donation area, which is the area with healthy skin. Skin grafts of thin thickness are usually taken from the front, called facial grafts, or can take the outer side of the thighs, abdomen, buttocks, back.

The pieces will be broken down in thickness to cover the large area. These pieces are fragile in nature and often have a shiny or smooth appearance. They may also be paler than adjacent skin. Pieces of detached thickness are difficult to grow as easily as non-grafted skin, so children who receive them may need additional grafts as they grow older.

3.2. Merge all thicknesses

A full thickness graft is to remove all the epidermis and dermis from the donor position. The abdomen, inguinal, forearm or area above the collarbone (collarbone) are places that are usually taken. They tend to be smaller, since the donor position is usually pulled together and closed in a straight line with sutures or pins.

Full thickness grafting is often used for small wounds in visible parts of the body, such as the face. Unlike grafted layers of small thickness, the grafted layers have a full thickness that blends well with the skin around them and often gives better aesthetic results.

Your doctor will probably schedule your skin graft a few weeks in advance, so you will have time to prepare for the surgery. Let your doctor know if you're on a prescription medication or not. Certain medications, such as aspirin, can reduce the formation of blood clots. Your doctor will instruct you to change the dosage or stop taking these medications before surgery. In addition, smoking or tobacco remedies will reduce your ability to heal skin grafts, so your doctor may ask you to pause smoking before surgery.

Your doctor also says you can't eat or drink anything after midnight of the day of the procedure. This prevents you from vomiting and suffocation during surgery if the anesthetic makes you nauseous.

You should also have a family member or friend to drive you home after surgery. Body anesthesia can make you sleepy after the procedure, so you should ask others to drive until the effects of the anesthesia are over.

You should also have someone stay with you for the first few days after surgery. You may need assistance to do certain work and travel indoors.

The surgeon will start by removing the skin from the donor position. If you are grafting skin of a thin thickness, the skin will be removed from an area of the body that is often obscured by clothing, such as the hips or outside of the thighs. If you are getting a full-thickness transplant, the abdomen, inguinal, forearm or area above the collarbone (collarbone) is the preferred organ donation site.

After the skin is removed from the donor site, the surgeon will carefully place it on the implant area and fix it with surgical bandages, needles or sutures. If it is a piece of detached thickness, it can be "meshed". The piece will be perforated by the doctor to stretch the piece of skin, from which they will take less skin from your donor site. This also helps the fluid to flow from under the grafted skin. Fluid capacitors under the graft can cause it to break down. In the long run, mesh grafting can cause the skin to graft in the form of a "fish net".

The doctor also bandages the donor's skin with a bandage that will cover the wound without sticking to it.

Healthcare workers will monitor for important post-surgery signs as well as take medication to manage the pain. If you have a thin skin graft, your doctor will likely keep you in the hospital for a few days to ensure that the donor piece and location are healing.

Within 36 hours, the piece will begin to develop new blood vessels and connect to the surrounding skin. If these blood vessels do not begin to form immediately after surgery, this suggests that your body is rejecting the piece.

The doctor can tell you that the piece of the puzzle "has not been done". This may be for a number of reasons including infection, hematoma or fluid under the graft as well as excessive movement of the graft on the wound. This can also happen if you smoke or poor blood flow to the transplanted area. You may have to re-operate with a new piece of the puzzle if the first piece is unsuccessful.

Upon discharged from the hospital, you will be prescribed painkillers by your doctor. They will also show you how to take care of the transplant site and donation place so that they are not infected.

The donation site will heal within one to two weeks, but the transplant will take longer. For at least three to four weeks after surgery, you should avoid performing any activity that may stretch or damage the transplant site. Your doctor will tell you when it is safe to resume your normal activities.

Source: healthline.com, nhs.uk