Skin transplant; Skin autografting; FTSG; STSG; Split thickness skin graft; Full thickness skin graft A skin graft is a patch of skin that is removed by surgery from one area of the body and transplanted, or attached, to another area. A skin graft is a surgical procedure in which a piece of skin is transplanted from one area to another. Often skin will be taken from unaffected areas on the injured person and used to cover a defect, often a burn. If the area of the skin defect is especially large, the harvested skin may be meshed to stretch it into a larger patch. If the defect
involves a great loss of tissue, a full thickness graft, a flap of skin with underlying muscle and blood vessles, may be required. Taking the graft from the injured person makes rejection of the tissue unlikely. The skin is the largest organ of the body. The skin and its derivatives (hair, nails, sweat and oil glands) make up the integumentary system. One of the main functions of the skin is protection. It protects the body from external factors such as bacteria, chemicals, and temperature. The skin contains secretions that can kill bacteria and the pigment
melanin provides a chemical pigment defense against ultraviolet light that can damage skin cells. Another important function of the skin is body temperature regulation. When the skin is exposed to a cold temperature, the blood vessels in the dermis constrict. This allows the blood which is warm, to bypass the skin. The skin then becomes the temperature of the cold it is exposed to. Body heat is conserved since the blood vessels are not diverting heat to the skin anymore. Among its many functions
the skin is an incredible organ always protecting the body from external agents. The skin covers the entire body, and acts as a protective barrier. Skin
grafts may be recommended for extensive wounds, burns, or specific surgeries that may require skin grafts for healing to occur. The most common sites of harvest for skin grafts are the buttocks and inner thigh, areas which are usually hidden and therefore cosmetically less important. DescriptionThis surgery is usually done while you are under general anesthesia. That means you will be asleep and pain-free. Healthy skin is taken from a place on your body called the donor site. Most people who are having a skin graft have a split-thickness skin graft. This takes the two top layers of skin from the donor site (the epidermis) and the layer under the epidermis (the dermis). The donor site can be any area of the body. Most times, it is an area that is hidden by clothes, such as the buttock or inner thigh. The graft is carefully spread on the bare area where it is being transplanted. It is held in place either by gentle pressure from a well-padded dressing that covers it, or by staples or a few small stitches. The donor-site area is covered with a sterile dressing for 3 to 5 days. People with deeper tissue loss may need a full-thickness skin graft. This requires the entire thickness of skin from the donor site, not just the top two layers. A full-thickness skin graft is a more complicated procedure. Common donor sites for full-thickness skin grafts include the chest wall, neck, back, or abdominal wall. Why the Procedure Is PerformedSkin grafts may be recommended for:
Full-thickness grafts are done when a lot of tissue is lost. This can happen with open fractures of the lower leg, or after severe infections. RisksRisks for anesthesia and surgery in general are:
Risks for this surgery are:
Before the ProcedureTell your surgeon or nurse:
During the days before surgery:
On the day of the surgery:
After the ProcedureYou should recover quickly after split-thickness skin grafting. Full-thickness grafts need a longer recovery time. If you received this kind of graft, you may need to stay in the hospital for recovery. After you are discharged from the hospital, follow instructions on how to care for your skin graft, including:
Outlook (Prognosis)Most skin grafts are successful, but some do not heal well. You may need a second graft. ReferencesPadilla PL, Khoo KH, Ho T, Cole EL, Sirvent RZ, Phillips LG. Plastic surgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 69. Ratner D, Nayyar PM. Grafts, In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 148. Scherer-Pietramaggiori SS, Pietramaggiori G, Orgill DP. Skin graft. In: Gurtner GC, Neligan PC, eds. Plastic Surgery, Volume 1: Principles. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 15. Version InfoLast reviewed on: 3/10/2021 Reviewed by: Tang Ho, MD, Associate Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What helps with skin graft pain?Recommended treatments include: (a) subcutaneous anesthetic injection of adrenaline-lidocaine; (b) ice application; (c) topical agents, such as lidocaine and bupivacaine; and (d) hydrocolloid- and polyurethane-based wound dressings accompanied with fibrin sealant.
How long does a skin graft take to fully heal?The donor area of partial thickness skin grafts usually takes about 2 weeks to heal. For full thickness skin grafts, the donor area only takes about 5 to 10 days to heal, because it's usually quite small and closed with stitches.
What are the stages of skin graft healing?There are three stages of skin graft healing: imbibition, inosculation, and revascularization.
What helps skin grafts heal faster?In some cases, hyperbaric oxygen therapy (HBOT) is recommended to facilitate healing, as it has been documented as a viable method to accelerate wound healing, salvage compromised grafts, and improve overall treatment outcomes.
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