Prior to Procedure

The wound will be cleaned.

Anesthesia

Depending on the surgery, you may receive:

• Local anesthesia—the immediate area is numbed
• Regional anesthesia—a large area of your body will be numbed, but you will be awake
• General anesthesia—you will be asleep

Description of Procedure

The wound will be measured. A pattern of the wound will be traced and outlined over the donor site. The donor tissue will be removed with a scalpel or special harvesting machine.

There are 3 main types of skin graft techniques. Your doctor will talk about the benefits and risks of options for you.

1. Split-thickness graft —The doctor will remove the top and middle layer of skin. This type of graft allows the area to heal more quickly. There may be color differences in this type of graft. Multiple holes are placed in the graft. This can give it a mesh appearance. The mesh allows fluid to leak out from the tissue under the graft. The meshed skin will be able to spread out over a much larger area of injury.
2. Full-thickness graft —The doctor will remove and transfer the entire thickness of the skin. Stitches are often needed at the donor site. The final outcome is usually better. This method is often used for areas where cosmetic outcome is important, such as the face. The use of full-thickness skin grafts is limited by size and donation area. It would be hard to close a large donation area with stitches.
3. Composite grafts —The doctor will remove a combination of skin and fat, skin and cartilage, or the middle layer of skin and fat. It is used in areas that need complex structure, such as the nose. These types of grafts are often removed from the ear.

The graft will be placed on the damaged site. It will be attached with stitches or staples.

A pressure bandage will be applied over the area. A wound vacuum-assisted closure (VAC) may be placed for the first 3-5 days. This device has suction and helps to control drainage from the wound. New blood vessels begin to grow into the wound within the first 48 hours. New cells will grow from the graft. Over time the new growth will cover the damaged area with new skin.

Skin Graft A split-thickness graft is fastened to the damaged site. Copyright © Nucleus Medical Media, Inc.

How Long Will It Take?

This varies according to your specific needs. The size of the graft and injury will play a role in the length of the surgery.

How Much Will It Hurt?

Removing skin grafts can be painful. Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medicine.

Average Hospital Stay

The hospital stay will depend on your needs. For example, a burn or accident may need a longer stay.

Postoperative Care

When you get home, you will need to:

• Keep the areas clean and dry.
• Avoid all trauma to the sites.
• Avoid periods of prolonged sunlight in area of new skin.
• Check the site for healing and good blood flow. There should be a healthy pink color in the skin.
• Follow instructions for bandaging. This will help to support the area while it heals. It will also help to prevent intense tightening of the skin called contractures.