Skin grafts and donor sites
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- A skin graft is a common surgical procedure.
- A section of skin of variable thickness is removed from an uninjured area. This is called the donor site.
- The skin from the donor site is placed on the site of the injury.
- The skin may be removed from other areas of the body. This will be discussed with you prior to the surgery.
- The graft will be secured by either sutures or staples. It will be covered with a dressing for 3-6 days.
Why might you need a skin graft?
A skin graft may be required:
- if the wound is too large to be directly closed
- to hasten healing
- to prevent infection
- to improve physical functioning
- for cosmetic reasons.
Types of skin grafts
- Meshed or sheet grafts are used to cover the site of the injury.
- Meshed grafts are made by passing the donor skin through a machine. The machine cuts small holes in the skin in a meshed pattern. This type of graft is used to expand the surface area of the skin. It allows any fluid build-up to pass through the graft, increasing the probability of the graft taking.
- A sheet graft is often used on the face and hands.
- The surgeon will discuss the type of graft that is suitable for your individual case prior to surgery.
Care of the donor site
- A donor site is an area where the surgeon has taken a layer of skin to create a graft.
- Only a fine layer of skin is taken, so healing should take 7–21 days.
- This may vary depending on the size, area and depth.
- It may also vary based on your age and medical history.
- The nurse will inform you when the dressing will be removed and how to care for the site.
- The dressing will stay in place for 3-6 days after surgery.
- It is important that you follow the instructions given to you during this period.
- If the graft is on a limb (arm or leg) you may be required to elevate it and rest in bed.
- This will help reduce swelling and pain and will help the graft 'take' to the new site.
- This may be required after the initial dressing is removed.
What to eat and drink
- It is important that you eat a well-balanced diet.
- You must drink plenty of fluids. Avoid caffeinated drinks (like coffee or cola) during this period of time.
- It is important that you stop smoking.
Using a splint
- A splint may be needed to immobilise (stop) movement of the grafted area if it is over a joint.
- Splints need to be kept in place 24hrs a day until you are advised that they can be removed.
- They may need to be worn after the dressing is removed.
- You will be advised about this and an exercise regime by the physiotherapist on days 4-6 after surgery.
Changing the dressing
- Prior to a dressing being removed you will be given some analgesia (pain relief).
- Your dressing may need to be replaced.
Care of the healed graft and donor site
- After the area is healed you must massage and moisturise the graft and the donor site.
- You should do this 3-4 times every day with a non-perfumed Sorbolene cream.
- The sites need moisture replaced regularly.
- If you don’t do this the wound may break down and further scarring can occur.
- It is vital to protect both areas from the sun for at least 12 months after surgery.
- Always use 30+ SPF sunscreen, sun protective clothing and a hat
- You may require dressings after discharge to the graft and/or donor site.
- This may occur in the Burns or Plastics Clinic or by your GP or community health nurse.
- You will then be followed up as an outpatient in the Burns or Plastics clinic.
- If you required a skin graft due to a burn, you will be seen by our Occupational Therapist.
- They will discuss options for scar management, for example pressure garments and topical silicone.
- They will also explain and encourage you to continue with massage and moisturiser.