Reconstructive Plastic surgery

Skin Graft Surgery

Skin grafts are used when a wound area is too big to be closed directly with stitches. The skin graft covers the wound and attaches itself to the cells beneath and begins to grow in its new location. If a skin graft were not performed, the area would be an open wound, and take much longer to heal.

The benefits of choosing a skin graft to close a wound is that  is is an easily repeatable procedure. It is easy to continue surveillance on the area that is covered by a skin graft.

The appearance is usually reasonable, but may have a slightly different colour.

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What is a skin graft?

Plastic surgeons use skin graft surgery to replace missing skin. If you’ve had surgery to remove skin cancer, your provider may recommend a skin graft to cover the missing skin. In most cases, this is a full thickness skin graft as these provide the best long-term appearance and they are usually associated with a more comfortable donor site (where the skin came from).

The recovery time after this surgery varies depending on your overall health, the size of the graft and the technique your provider used. Most skin graft procedures are successful the first time. Sometimes, the transplanted skin doesn’t heal well or “take” to the surrounding skin. If this happens, you may need another skin graft.

What are the types of skin graft surgery?

The types of skin graft surgery are:

  • Full-thickness skin graft (FTSG): During an FTSG, your surgeon removes and transplants the top layer and the entire second layer of skin. FTSG procedures require more healing time than STSG because the transplanted skin is thicker. Providers may choose FTSG for a part of the body that you don’t usually cover up with clothing, such as the face. For FTSG, providers often remove healthy skin from the groin, arm or collarbone area and then close the donor wound right away.
  • Split-thickness skin graft (STSG): During this procedure, your surgeon removes the top layer of skin (epidermis) and only part of the second layer (dermis). Providers usually use STSG to cover large areas of damaged or missing skin. They typically take healthy skin from the thigh, bottom, belly or back. The area where the skin was removed from (donor skin) normally heals on its own over 1-2 weeks.
  • Composite graft: During this procedure, your surgeon transplants skin as well as cartilage or other soft tissues. Composite grafts can repair damage to the nose, fingertips and ears.

What does a skin graft treat?

Your surgeon may recommend a skin graft if you have damaged or missing skin that cannot heal on its own. Skin grafts help people who have skin loss due to:

  • Burns.
  • Infection.
  • Surgery to remove skin cancer
  • Skin ulcers and bedsores (pressure injury).
  • Slow-healing wounds or very large wounds.
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Recovery and rehabilitation

What happens after skin graft surgery?

A skin graft usually involves two surgical sites (the donor site and the graft site). Your surgical team will monitor your health, look for signs of infection and make sure both sites are healing properly.

After surgery, you may need to stay in the hospital. The length of stay depends on the type of skin graft surgery you get. Follow your surgical team’s instructions when you go home from the hospital. They may ask you to:

  • Wear a cover or dressing over the wounds: Ask your surgeon how long you should keep the dressing in place, whether you can get it wet and how often you should change it.
  • Keep the wound protected: Avoid physical activity that could damage the graft site during the healing process. Don’t stretch the skin or do strenuous exercise for three to four weeks.
  • Take medications to manage pain: To relieve pain after surgery, your surgeon may prescribe pain relief medication. You may also need other drugs to reduce inflammation or prevent infection.
  • See your surgeon for follow-up visits: Your surgeon will want to see your skin and make sure you’re healing properly. They may recommend a physical therapy (PT) program to improve the skin’s elasticity and prevent scar tissue from building up on the graft site.
Scar,from,the,previous,harvesting,side,of,skin,graft
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What else you should know

What are the advantages of a skin graft?

Skin grafts can replace lost skin, improve the appearance of damaged skin and restore function. This surgery is an effective treatment for skin loss that results from many different conditions.

 

What are the risks or complications of skin graft surgery?

Most skin grafts are successful. But sometimes the transplanted skin doesn’t take to the new area. If the transplanted skin doesn’t take, you may need another skin graft. An unsuccessful skin graft usually results from:

  • Blood or pus pooling underneath the transplanted skin.
  • Infection.
  • Injury or damage to the graft site (such as moving the newly transplanted skin too much while it’s healing).
  • Problems with blood circulation that cause the wound to heal too slowly (this happens more often in people who smoke).

Other complications of skin graft surgery include:

  • Bleeding.
  • Contracture, when the grafted skin shrinks and pulls in at the edges.
  • Discoloured, patchy or uneven skin.
  • Loss of skin sensation or increased sensitivity to pain.
  • Pain that lasts after the area has healed (chronic pain).
  • Scar tissue building up around the graft site.
How will my RPS team manage my post-operative care?

The RPS team will give you specific advice regarding your individual post-operative recovery. They will advise:

  • where you will go after your surgery
  • what medication you will be given or prescribed
  • what bandages and dressings you will need and when they’ll be removed
  • if you require stitches, when they’ll be removed
  • when you can get back to normal activity and exercise
  • when to book your follow-up care.
Our Canberra specialists

The team at RPS Canberra are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Our surgeons hold an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.

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