What you need to know about skin grafting?

What is a skin grafting?
Skin grafting is a surgical procedure that involves the removal of a healthy skin tissue from one area of the body and moving it, or transplanting it, to a different area of the body.
A skin graft is the healthy skin taken from an area of your body called the donor site. The skin may be taken from an area near the injury to match the area where the graft will be placed. Grafts that are artificial or come from another person or animal may be used temporarily. These are used as covers when large areas of the skin are damaged. They are replaced with your own skin over time.

Who needs skin grafting?
Skin grafting is recommended for people who fall into the following categories:
A large amount of skin loss caused by infection
Burns
Very large wounds that will not been able to appose surgically
Cosmetic reasons or reconstructive surgeries where there has been skin damage or skin loss
Skin cancer surgery
Surgeries that need skin grafts to heal
Venous ulcers, pressure ulcers, or diabetic ulcers that do not heal

What are the types of skin grafts?
Full-thickness grafts are used for deep wounds, so all the layers of skin are taken for the graft. This type of graft is used when it is important to match your skin color, such as on your face. It may also be used when tightening of the skin should be avoided, such as on the fingers. The graft will be trimmed to the correct size and shape to fit the wound.
Split-thickness grafts are used for shallow, large surface area wounds. The top 2 layers of skin are taken for the graft. This type of graft is also used when more blood and fluid are expected to drain from the wound. The graft is applied as a sheet if the wound is on your face, neck, or hand. It is meshed (cut and stretched) if it is not large enough to cover the wound.

How do I prepare for skin grafting
Depending on the type of skin grafting,, you will be told specifically how to prepare. You might be told not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery or plan to stay over at the hospital for a few days to ensure the area is immobilized to prevent shifting of the graft.
Tell your surgeon about all medicines you currently take. You will be advised if you need to stop any medicine before your surgery, and when to stop.
You may need to have blood tests, an ECG, x-ray, or other tests.
There might be need to prepare your wound and donor sites before the surgery. Cleaning of the wound site by removing dead tissue can also be done ahead of your surgery and you may be asked to keep the wound free from germs until your surgery.
An anesthesiologist may talk to you before your surgery.

Depending on the surgery, you may receive:
Local anesthesia—the immediate area is numbed
Regional anesthesia—a large area of your body will be numbed, but you will be awake
General anesthesia —you will be asleep .
Most skin grafts are done under general anesthesia, which means you’ll be asleep throughout the procedure and won’t feel any pain. If your procedure is under local anesthesia, you will be given medications to control pain during the procedure. It is important to inform the anaesthetist if you or anyone in your family has had a problem with anesthesia.

During your surgery:
The pattern of the wound will be drawn over the skin of the donor site with a surgical marking pen. If the skin graft will come from your body, the graft will be taken from the donor site using a scalpel or special harvesting machine . After the graft is fitted and placed over the wound, surgical stitches or staples will be used to attach it in place. The donor site will also be closed with sutures or surgical staples. Bandages will be placed over the graft and donor sites.

What should I expect after skin grafting?
Medicines will be given to prevent or treat pain, severe itching, or an infection.
Bandages will cover the surgery area to hold the graft in place. Do not remove the bandage yourself. In the hands or other mobile parts of the body,you may also have a cast in place to help immobilize the area to secure the graft. Your healthcare provider will arrange for the bandage to be removed or changed after a few days. Keep the bandage clean and dry.
You may need to avoid certain activities , such as exercise or lifting heavy objects.Avoid periods of prolonged sunlight in area of new skin. You may also need to avoid activities that can irritate your wounds. Your surgeon will tell you which activities to avoid or limit.
The donor site will heal within two weeks, but the graft site will take a bit longer to heal. For at least three to four weeks after the surgery You will be told when it’s safe to resume your normal activities.

What are the possible complications of skin grafting?
Problems from the procedure are rare, but all procedures have some risks; After your surgery, you will be reviewed frequently for potential problems, like:

1.Bleeding
2.Graft failure
3.Infection at either the donor or recipient site
4.Increased or decreased sensation at the recipient site
5.Hair may not grow on recipient site
6.Graft tissue contracts, interfering with limb movement
7.Scarring
8. A collection of blood outside of a vessel, known as a hematoma
9.Differences in skin coloration

Factors that may increase the risk of complications include:
A. Age—newborns, infants, or adults aged 60 years and older
B. Smoking
C.Diabetes,heart and liver diseases
D.Use of certain medications
E.Poor nutrition or a weak immune system may also cause problems with healing.