When getting a skin graft, your doctor will take some skin from a "donor" site to help cover the wound created by excisional surgery. The skin is sewn into the wound and as it heals, fuses with the existing skin. That means you will have two wounds to care for - the donor site and the recipient site.
Partial vs Full Thickness Skin Grafts
A partial thickness skin graft is when your doctor removes the epidermis and part of the dermis from the donor site, allowing the skin at the donor site to regenerate itself. When doing a partial skin graft, your doctor may use skin from your thigh, buttock, back, upper arm, forearm or abdominal wall. He will look for skin that has the same appearance and color as the recipient site so as it heals it looks the same.
A full thickness skin graft uses the epidermis and the dermis. It must be sticked back together since it cannot regenerate itself without the dermis.
The doctor will look for an area where the skin can be removed and the remaining skin sutured without leaving too much of a scar. This includes areas such as the ear, inner elbow, eyelid, groin and areola. They are often used when the skin graft is needed on the face or neck.
The removed skin is placed on the recipient area and fastened with staples or sutures. A pressure bandage is applied and a wound VAC may be placed on the wound to control drainage for three to five days.
Within three days, the skin graft will begin producing new blood vessels and new skin will begin to cover the wound.
Before Your Surgery
Your doctor will provide detailed instructions for preparing for your surgery. Some general things to keep in mind include:
- Make sure your doctor is aware of all medications, including over-the-counter medications, vitamins and supplements you are taking. Ask which medications you can continue taking up until and after your surgery.
- Discontinue use of aspirin, ibuprofen and prescription blood-thinners, such as Coumadin. Be sure to talk to your prescribing doctor before discontinuing Coumadin.
- Be aware of how long before surgery your doctor wants you to refrain from eating or drinking anything. This is usually between 8 and 12 hour before your surgery.
- Make sure you have someone who can drive you to and from surgery (if needed) and help you when you return home.
- Remove or move any items in your house that could cause you to trip or fall.
After the Surgery
Your doctor will provide you with detailed wound care instructions. In general, you should:
- Keep the wound area dry and clean. Cover with plastic wrap when bathing or showering.
- Take steps to prevent any trauma to the wounds. Protect the wound from being hit and avoid exercise for several weeks.
- Change your dressing as instructed by your doctor. Your doctor may not want the bandage removed until a follow-up office visit. Your doctor may want a dressing to remain on for a few weeks.
- Protect the wounds from direct sunlight for prolonged periods of time.
- Keep your wound elevated when possible.
- Your skin graft may look pink or red for a few months. This is normal. Over time, the color will change.
What to Expect: Excisional Surgery
"Discharge Instructions for Your Skin Graft Site," Date Unknown, Staff Writer, Einstein Healthcare Network
"Skin Grafts," Date Unknown, Staff Writer, Department of Dermatology, University of Virginia Health System
"What You Need to Know About Skin Grafts and Donor Site Wounds," 2007, Staff Writer, WoundsInternational.com