Why would someone need a skin graft?
Skin grafts are used on persistent wounds that aren't healing properly. For example, people who are diabetic and have poor circulation might have wounds that aren't healing quickly enough and require a skin graft.
People who suffer from traumatic injuries, such as large burns, also are candidates for skin grafts. Because some burn victims have lost the top layer of their skin, allowing the wound to heal on its own can take several months. Skin grafts can help burn victims heal more quickly.
Before the skin graft, your doctor will likely want to remove dead skin, tissue and foreign materials, a process referred to as debridement.
Once your wound is ready, the doctor will choose which skin graft is best for you. Sometimes doctors use the patient's skin to create the skin graft. This is especially true for patients with large wounds.
To make the graft, a thin layer of a person's skin is taken, often times from the buttocks or inner thigh. It is then placed in a machine that will stretch the skin, sometimes to two or three times its original size, and also poke several small holes in it. The injured skin beneath the graft can then grow through the holes as part of the healing process.
If a person has deep tissue loss, he or she will have to undergo a more complicated skin graft where doctors might use skin and tissue from the person's chest wall, back or abdominal wall.
For smaller grafts, a doctor might use a graft made of secondary skin products grown in cell culture dishes. Other skin grafts are made from donated skin that has been frozen.
Depending on how much skin you need, the procedure can take between 30 minutes and two hours. The time it takes will largely depend on the size of the wound and how much skin is needed to repair it.
If you have suffered a large injury from a traumatic event, you will likely have the procedure done under anesthesia in an operating room. Smaller skin grafts are outpatient procedures that can be done in clinics.
Does it hurt?
After surgery, yes. If your doctor uses your skin to make the graft, then the donor site will feel similar to road rash and hurt for about 10 days.
If you receive donated skin or a secondary skin product, you will likely feel some soreness around the wound.
What are the risk factors?
With small skin grafts, there's a low risk that the graft won't hold and that you'll have to receive more skin grafts. Also, about one in 100 patients that receive a skin graft using secondary skin products experience an allergic reaction.
With larger skin grafts, there's a risk that your wound won't get covered quickly enough and is at risk of becoming infected.
With any surgery, there's a risk associated with anesthesia and also a risk of bleeding infection. Risks specific to skin grafts include lost sensation in the skin, increased sensitivity, scarring, skin discoloration and uneven skin surface. Chronic pain is another risk factor, but it's rare.
What's the recovery time?
Your recovery time will depend on the size, depth and complexity of your skin graft.
People who require small grafts will likely go home the same day and heal fairly quickly. If your graft required a hospital stay, you will likely go home within a day or two if it wasn't a large graft. Patients with larger and thicker grafts might be in the hospital one to two weeks.
For patients with extensive damage, it can take about three to four weeks to heal. Also, patients with poor blood flow and patients who smoke will not heal as quickly.
What's the follow-up?
Generally, skin graft patients go back after about a week, sometimes to get their bandages replaced. Your doctor will want to see you periodically after the procedure to ensure that the graft is holding and that you won't require further procedures. It's important to be open and honest with your doctor at every step of the way to better ensure a positive outcome.
Source: Dr. William Truels, medical director of the Deaconess Wound Care Center; American Diabetes Association