What is a skin graft?
A skin graft procedure takes skin from one part of your body to be applied to a different part of your body.
Why would I need a skin graft?
A skin graft is usually used when a wound or skin loss area is large and so cannot be closed by stitches alone. This can happen after burn injuries, trauma or skin cancers.
Occasionally, the wound could be closed by stitches but will be too tight and so could cause problems - examples include the fingers where a tight closure could impair normal finger movement.
What types of skin graft are there?
Skin grafts can be either 'split thickness skin grafts' or 'full thickness skin grafts'.
What is a split skin graft?
A split skin graft uses just the very top layer of skin. The area used is often the upper thigh or buttock, but split skin grafts can be taken from many other areas such as the inner arm, scalp or back; the lower portion of the skin is left intact and will heal up, usually in two weeks.
The area used to take the graft from will feel sore for a couple of days, usually like a graze. The area will often be dark red for a few months, then pale in colour.
What is a full thickness skin graft?
A full thickness graft uses the full depth of skin. The area used is then closed with stitches, so for this reason the graft size is limited by the laxity of the surrounding skin. Commonly used areas are the groin crease, the neck or the upper inner arm.
The area will have a linear scar that is often red at first, but should turn pale after about a year.
What type of skin graft will I need?
Different types of wounds need different grafts. Large areas, such as burns, usually need split skin grafts, whereas areas such as eyelids usually need full thickness grafts. Your specialist will be able to discuss which graft you need.
How does a skin graft work?
The skin graft is placed onto the wound, and held in place with either stitches or glue. A secure dressing is then placed or stitched over the graft.
Over the next few days, the skin graft receives nutrients from the underlying tissue. Within 3-4 days new blood vessels grow into the skin graft, and at this point the graft has 'taken' (worked).
For this reason, your dressings will usually be kept in place for 4-5 days before the graft is checked, although some specialists do check grafts slightly earlier or later than this.
What are the risks of having skin grafts?
Scarring - the area the skin graft has been taken from will heal by scarring. In the case of a full thickness skin graft, the scar will be a single linear scar, whereas a split skin graft leaves a larger rectangle of pale scar which often fades almost completely.
Infection - infection from the donor area will usually settle with antibiotics. Infection of the skin graft, though, may result in the graft failing to work and more surgery may be needed.
Bleeding - bleeding under a skin graft can cause it to fail. For this reason your specialist may ask you to stop taking medication such as Aspirin or Warfarin before the operation, but always check before altering any of your usual medications.
- Graft failure - some, or all, of the skin graft may not work. If just a small part of the graft fails to work then it is usually left to heal up on its own. If a large area of skin graft fails, then the graft may need to be re-performed.
This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer