Skin Grafts

After a severe burn, a pressure ulcer, or a surgical procedure, some of the skin on the patient may be taken away. If the damage is so great that the skin cannot regenerate on its own, the patient may need a skin graft. A skin graft is replacing layers of skin on the body of a patient. Although this process is long, painful, and takes long it heal it does save the lives of many people every year especially in case of burns (Roos). There are four main types of grafts. The most preferred choice is an autograft.

In an auto graft, skin is taken directly from the patient so that there is no fear of rejection. The second type is isografts. This involves taking skin from an identical twin and is also preferred because there is little fear of rejection as well. These two are usually successful if they don’t become infected and if they get an adequate amount of blood. The other two are allografts, which is skin being taken from a different person that is not identical to the patient, and a xenograft. This is using a graft from an animal (Marieb422).

After these, there are three levels of thickness used in a skin graft. Split-thickness grafts are used for the more shallow grafts, such as damage to only the epidermis. Full-thickness grafts are for severe injuries that damage the dermis and epidermis. These also include the hair, blood vessels, and glands of the skin and usually function better than Split-thickness grafts. Composite grafts contain more than just skin like bone or cartilage, such as in a nose graft, the doctor will have to use cartilage as well to give the nose structure.

After the depth and the type of graft is decided the physician will begin the process of placing the skin graft onto the patient. First the doctor must remove all infected, burnt, or unhealthy skin from the area. For many this is a very painful process that is usually treated with general anesthetics or local anesthetics. The process of cleaning the wound is to debride the wound. Next the physician will use an instrument know as a dermatome, this is an instrument that will remove the skin from the donor site.

To describe the dermatome it is very much like a very exact cheese slicer but for the skin. After the desired depth is reached, the surgeon will place the skin graft over the wound. For more serious injuries the donated skin may be run through a machine that will turn the skin into a mesh-like sheet allowing the doctor to stretch the donated skin more and maximize its usage. After the skin is in place it will be attached to the body with stiches or surgical staples (Roos).

After everything is set, the surgery is over. Next, however, is recovering from the surgery. Recovery time depends mostly on the type of skin graft and where the graft is. For the most serious of skin grafts patients may have to stay in the hospital for 1 to 2 weeks. For shallower grafts most can leave the hospital after a short stay and must avoid strenuous activities so that the skin graft has a chance to heal (Bhimji). If the procedure works, blood vessel growth could start within thirty-six hours (Chwistek).

Although skin grafts have been used for years, many times the surgery will fail, reasons for a skin graft to not “take” would be not having a well vascularized skin bed for the new skin to grow on, sheer force on the graft, infection by bacteria, and if large amounts of seroma and hematomas prevent contact between the graft and the skin bed (Gingrass 10). To prevent these, the graft must be covered with fresh bandages constantly and keep out interstitial fluids like seroma so that the tissue and have a good “take”. One method used is a vacuum-assisted closure which will draw out all the fluid (Roos).

After the surgery, patients will also have to take immunosuppressive therapy which will stop the body from attacking the foreign skin. Many will have to take these drugs for the remainder of their lives but some are able to take away the drugs in rare cases. If these measures are taken, the skin graft may be successful and the patient will now have a new layer of skin. However, if the graft does not succeed a new skin graft will need to be taken, and the long painful process will have to be restarted again. Works Cited Bhimji, Shabir.

“Skin graft. ” MedlinePlus. A. D. A. M. , Inc. , 22 Mar 2013. Web. 16 Apr 2013. . Chwistek, Marcin. “Skin Graft. ” Swedish Health Library. Swedish Medical Center, 23 11 2012. Web. 16 Apr 2013. Gingrass, Ruedi. Essentials for Students: Plastic Surgery. 7th ed. Arlington Heights: Plastic Surgery Educational Foundation, 2007. pg. 10. Web. . Roos, Dave. “Skin Grafts. ” Discovery Fit & Health. Discovery Communications, LLC, n. d. Web. 11 Apr 2013. http://health. howstuffworks. com/skin-care/information/anatomy/skin-graft. htm (general info).

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