Skin grafts are modern technology’s way of helping your body to knit together new skin. Donor skin from another part of your body – or another person – replaces skin damaged due to burns, illness, malformation or injury. There are two different types of skin grafts, full thickness and split thickness, that plastic surgeons use to cover the area in need. Skin grafts result in scars on both the donor site and the graft site.
Types of Skin Grafts
The type of skin graft used affects both the visual results and recovery time. During this surgical procedure, a tool called a dermatone is used to remove skin from the donor site. The donor skin is stitched into place. Both sites are covered with dressings to prevent infection while they heal. A split-thickness skin graft takes only the upper layers of skin from the donor site, allowing the site to eventually regenerate more skin. A full-thickness graft uses the entire dermis to cover the site. Similar to a skin graft is a flap, which takes the full skin layer, as well as muscle, blood vessels, fat and sometimes even bone. A flap is typically used when the area in need has poor blood flow.
The ideal donor skin is a healthy portion with similar properties taken from another part of the person’s body. Doctors typically try to extract skin from an area that will heal relatively quickly and can be covered up with clothing to hide the resulting scar. Doctors use sites such as the thigh, abdominal wall, back, buttocks, upper arm and back for split-thickness skin grafts. Full thickness donor sites are stitched closed by the surgeon, so areas such as the ear, collarbone, inner elbow, groin and scalp are good candidates. If the area receiving the graft is very large, the skin taken from the donor site may not be as large in area. In some cases, medical procedures involving mesh are used to double the size of the skin before it’s stitched into the new location. This lowers the impact on the donor site.
Split-thickness grafts typically heal in about two to three weeks. Full-thickness grafts take about twice as long, depending on the depth and size of the area. A flap can take up to two months to heal. It’s important that patients follow the wound care instructions from their surgeon to prevent complications and to minimize scarring.
Scars for full-thickness skin grafts are usually heavier and thicker than split-thickness grafts. They take longer to fade, but there are several things that patients can do to minimize scarring. Very wide or raised scars can be reduced by a plastic surgeon at a later time. Once wounds have healed, a silicone-based scar fading cream or sheet can be applied to both sites to help them heal faster. For example, keeping the body hydrated and avoiding sunlight helps to reduce scars. Although the skin may itch, it’s important to refrain from scratching or picking at the scabs. Keeping dirt and oils away from the surface while wounds are healing reduces the chances of infection, which improves the result.