Skin Graft

Why the Procedure Is Performed

Skin grafts may be recommended for:

• Areas where there has been infection that caused a large amount of skin loss
• Burns
• Cosmetic reasons or reconstructive surgeries where there has been skin damage or skin loss
• Skin cancer surgery
• Surgeries that need skin grafts to heal
• Venous ulcers, pressure ulcers, or diabetic ulcers that do not heal
• Very large wounds
• A wound that the surgeon has not been able to close properly

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.

Risks

Risks for anesthesia are:

• Reactions to medicines
• Problems with breathing

Risks for this surgery are:

• Bleeding
• Chronic pain (rarely)
• Infection
• Loss of grafted skin (the graft not healing, or the graft healing slowly)
• Reduced or lost skin sensation, or increased sensitivity
• Scarring
• Skin discoloration
• Uneven skin surface

Before the Procedure

Tell your surgeon or nurse:

• What medicines you are taking, even drugs or herbs you bought without a prescription.
• If you have been drinking a lot of alcohol.

During the days before surgery:

• You may be asked to stop taking medicines that make it hard for your blood to clot. These include aspirin, ibuprofen, warfarin (Coumadin), and others.
• Ask your surgeon which drugs you should still take on the day of your surgery.
• If you smoke, try to stop. Smoking increases your chance of problems such as slow healing. Ask your doctor or nurse for help quitting.

On the day of the surgery:

• Follow instructions about when to stop eating and drinking.
• Take the drugs your surgeon told you to take with a small sip of water.

After the Procedure

You 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 1 to 2 weeks.

After you are discharged from the hospital, follow instructions on how to care for your skin graft, including:

• Wearing a dressing for 1 to 2 weeks. Ask your provider how you should care for the dressing, such as protecting it from getting wet.
• Protecting the graft from trauma for 3 to 4 weeks. This includes avoiding being hit or doing any exercise that might injure or stretch the graft.
• Getting physical therapy, if your surgeon recommends it.

Outlook (Prognosis)

Most skin grafts are successful, but some do not heal well. You may need a second graft.

References

Scherer-Pietramaggiori SS, Pietramaggiori G, Orgill DP. Skin graft. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 17.