Split-Thickness Skin Graft

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KEY POINTS

• A split-thickness skin graft is a procedure in which a surgeon removes the outer layer of skin from a part of your body and uses it to cover an open wound in another part of your body. This procedure can help a wound heal sooner with less chance of infection.
• This procedure is done when you have an open wound, such as a deep burn, and most or all of the skin has been lost.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is a split-thickness skin graft?

A split-thickness skin graft is a procedure in which a surgeon removes the outer layer of skin from a part of your body and uses it to cover an open wound in another part of your body.

When is it used?

This procedure is done when you have an open wound, such as a deep burn, and most or all of the skin has been lost. This procedure can help a wound heal sooner with less chance of infection. Large wounds will not heal without a skin graft. You may need more than one skin graft to completely cover a large wound.

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food or medicine allergies.
• Your provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your provider gives you.
• Ask any questions you have before the procedure. You should understand what the healthcare provider is going to do and how long it will take you to recover.

What happens during the procedure?

The surgery is usually done at the hospital.

You will be given medicine called anesthesia to keep you from feeling pain during the surgery. You may have:

• Regional anesthesia, which numbs part of your body while you stay awake. If you have regional anesthesia, you may also be given medicine to help you relax. The medicine can make you drowsy or you may fall asleep before the procedure.
• General anesthesia, which relaxes your muscles and puts you into a deep sleep. A breathing tube is usually put in your throat when you have general anesthesia.

Your healthcare provider will clean the wound and remove any dead or damaged tissue. Your provider will remove a piece of the top layer of healthy skin from one part of your body, such as the upper thigh. This is called the donor site. Your provider will place the skin onto the wound and keep it in place using stitches, staples, or pads. The skin will be covered with a bandage. A splint may be placed around the bandage to protect it. The donor site will be covered with a special bandage to decrease pain and help it heal.

What happens after the procedure?

You may be in the hospital for a few hours or days, depending on your condition and where the graft is placed. The graft may take 5 to 7 days to attach. It may take longer than this for the graft to completely heal, depending on its size.

Follow your healthcare provider’s instructions. Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection or bleeding.
• The graft may not attach correctly.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.