Plastic Surgery Clinic Skin Grafting Information
What is a skin graft? Skin grafting is a type of surgery involving the transplantation of skin. The transplanted tissue is called a skin graft. The area the skin is taken from is called the donor site. Why are skin grafts used? Skin grafts are used to close a wound where there has been some skin loss, e.g. ulcers, burns, abrasions, skin cancer and sometimes in breast surgery. What are the treatment options for open wounds? When there is an open wound that is taking a long time to heal, the options are: Leave it to heal (which may take months or longer) or to cover the wound. The simplest way to do this is with a skin graft. There are two types of skin graft: A thin split skin graft A full thickness skin graft The type of skin graft you require will depend upon the position and depth of skin loss. 2
The surgical procedure You may have either a general or a local anaesthetic depending on the area being grafted. Your consultant will give advice on which graft is best for you and discuss options for where the skin can be taken from as there may be scarring at the donor site. Length of stay in hospital Skin grafting is normally done as a day case procedure but you may require a short stay in hospital. Your consultant will advise you accordingly. What to expect following surgery? Split skin graft Once the skin layer has been removed from the donor site, it is laid over the area where the skin loss has occurred. It may be secured in place with stitches. You may also have a sponge or cotton wool stitched over the graft to keep it in contact with the blood supply underneath, allowing it to take and survive. This usually takes 5-7 days. The dressing will be removed in the dressing clinic between 5 to 7 days following surgery. The Donor Site The site will be covered with a bulky dressing and bandage to protect it from infection. This should be left in place for 2 weeks. You may need to re-apply the outer bandage during this time but must leave the inner dressing undisturbed to allow healing to take place. 3
For a split skin graft the donor site should heal in about two weeks, but the area may remain red for some time after this. You will be given an appointment to attend the dressing clinic two weeks after your surgery for this to be reviewed. Full thickness grafts The site will be covered with a simple dressing following surgery. This will be reviewed in the Dressing Clinic one week following surgery. With a full thickness graft, the donor area will be stitched and will take about five days to heal and will leave a small scar. Risks of the skin graft surgery Bleeding It is normal to have some minor bleeding around the graft site. This is a good indication that there is healthy tissue for the graft to stick to. Excessive bleeding should be reported to your consultant or nurse so the wound can be checked. Infection If you notice an increased redness of the wound and it is more painful than it has been, please contact your consultant or nurse to have it checked as soon as possible. 4
Pain It is normal to experience some pain or discomfort after this type of surgery. The donor area can often feel more uncomfortable than the grafted area, and you may need to take regular pain relief as prescribed by your consultant. Skin grafting may take place under local anaesthetic. However, sometimes a patient will require a general anaesthetic. If this is the case, further information regarding the risks associated with general anaesthetic will be given at your planned pre-operative assessment appointment. Review /Aftercare Recovery time You will need to take things gently for the first two weeks to allow the graft to heal properly. The grafted area is quite fragile, so it is important not to rub or brush against the graft or the dressing, or to put any pressure on the area as this could lead to failure of the graft to take. Avoid any kind of exercise that might stretch or injure the graft for a few weeks. Then start with some gentle exercise and build up gradually. You might need to take some time off work, depending on where the graft is and the kind of work you do. Your consultant will give you more advice on this. If the grafted area is on your hand, you may have a sling to help keep your arm raised as much as possible. If the graft is on your leg, you will most likely have a padded bandage from toe to knee. 5
Please bring suitable footwear with you that will accommodate this bandage e.g. an old loose slipper or wide training shoe. It is important to keep your leg up whenever possible as this helps prevent swelling and reduces pain. Appearance There will be some difference between the grafted skin and the skin in the surrounding area. This should lessen over time. If you are concerned about the appearance of the area, you could try camouflage make-up. Your clinic nurse may be able to advise you about this. If necessary, you will be given a further appointment to monitor the healing of the graft and to check the donor site. When both wounds are healed sufficiently, you will be advised to apply a moisturising cream twice a day. The consultant plastic surgeon or one of his team members will see you after approximately 3 months to review the outcome of the skin graft. He will also advise you further depending on your particular circumstances. 6
Contact Information You will be given a contact telephone number should you have any queries or experience any problems during your recovery. Alternatively please contact your consultant s secretary via the main Switchboard. 01536 492000 7
If you need this information in another format or language, please telephone 01536 492510. Further information about the Trust is available on the following websites: KGH - www.kgh.nhs.uk NHS Choices - www.nhs.uk Ref: PI 784 March 2018 Review: December 2019