What to Expect From a Skin Graft
A skin graft is a surgical procedure in which an area of skin that has been damaged to the point of being unable to repair itself is replaced with
healthy skin . The healthy skin is usually removed from one area of a person’s body and transplanted to the damaged area, though skin from a donor can be used in some cases.
Skin grafts are used to treat burns and ulcers, as well as in reconstructive surgeries. In general, the outcome for this type of surgery is excellent.
Reasons for a Skin Graft
Skin grafting may be used for skin that has been damaged by:
Who Is Not a Good Candidate
Skin grafts carry more risks for young infants or those over 60. Smokers and those with chronic illness are also at higher risk, as are people who take certain medications such as high blood pressure drugs, muscle relaxants, and insulin.
People with uncontrolled skin cancers or active infections cannot receive a skin graft.
A skin graft is not appropriate for deep wounds that have penetrated into the tissue beneath the skin or in which bone is exposed. These normally require the use of skin flaps or muscle flaps, where the transplanted tissue has its own blood supply.
How to Prevent and Treat Pressure Ulcers
Types of Skin Grafts
There are three main types of skin grafts:
Face grafts are usually small, full-thickness, or composite grafts. Donor sites include in front of or behind the ear for full thickness grafts and the ear itself for composite grafts.
Types of Donors
The most successful skin grafts are typically those that use the patient’s own skin. Known as autografts , skin is harvested (removed) from another area of person’s body. Surgeons make an effort to choose a donor site that is normally covered by clothes.
They will also try to match skin color and texture as closely as possible between the donor and recipient sites. The inner thigh and buttocks are the most common donor sites. The upper arm, forearm, back, and abdomen may be used as well.
Skin grafts can also be successful when harvested from an identical twin of the patient. When a separate donor is not an identical twin, there is a stronger chance of the body rejecting the new skin because the body sees it as foreign and attacks it via the immune system.
Alternative graft sources are meant only for temporary use before and autograft or until the patient’s own skin grows back. Such sources include:
Synthetic skin, made in a laboratory, may be used in specific circumstances, such as for superficial burns. Currently, its use is limited and more research needs to be done before it becomes a true option.
Your skin graft surgery will be scheduled several weeks in advance. Your doctor may want you to stop certain medications—such as aspirin and warfarin—that can interfere with the blood’s ability to form clots; always tell your doctor ahead of time about any prescription or over-the-counter medications you’re taking.
Disclose any smoking or other use of tobacco products to your doctor. These will affect the skin’s ability to heal after a graft.
Here is a step-by-step description of how skin graft surgery is performed:
Risks and potential complications of skin grafts include:
The Risks of Having Surgery
Within the first 36 hours after surgery, the graft should begin to grow new blood vessels which then connect to the recipient’s skin that surrounds it.
Recovery after receiving a skin graft will vary depending on the complexity of the procedure. A split-thickness graft may heal after only a few days. Full-thickness grafts take longer to heal and may require a one- to two-week hospital stay.
The donor site typically takes anywhere from a few days to a week or so to heal.
With an allogenic transplant, you will be given immunosuppressive drugs to prevent your body’s rejection of the donated skin. Because these drugs suppress the immune system, they increase vulnerability to infections and may have toxic effects on other organs, such as the kidneys.
After you are discharged from the hospital you will wear a dressing for one to two weeks. Ask your provider how you should care for the dressing and protect it from getting wet. You will also need to protect the graft from trauma for three to four weeks. This includes avoiding being hit or doing any exercise that might injure or stretch the graft.
In some cases, your surgeon may recommend physical therapy if your graft interferes with being able to move one of your limbs or joints fully. Your doctor will likely give you a prescription for painkillers to help minimize pain.
Recovering From Surgery
The prognosis for most skin grafts is very good. The reason for your surgery is a more likely determinant of your prognosis, however.
In some cases, infection, fluid, or blood collecting under the graft, or too much movement of the graft on the wound, can interfere with the graft healing properly. This may also happen if you smoke or have poor blood flow to the area being grafted. You may need another surgery and a new graft if the first graft doesn’t take.
Support and Coping
How you feel after having a skin graft will most likely depend on the reason for and location of the graft and its appearance after it’s healed. Your doctor can provide resources if you want to seek support among a community of people who have undergone grafts for similar reasons, such as burns, skin cancer, or reconstructive or plastic surgery.
Was this page helpful?
By Natalie Kita
William Truswell, MD Updated on March 04, 2020
Medically reviewed by
Morsa Images / DigitalVision / Getty Images
Venous (varicose) ulcers
Pressure ulcers (bedsores)
Contracture (when skin becomes too tight while healing and limits movement of joints)
Nipple and areola reconstruction