Skin Grafts & Other Surgical Procedures
Not all wounds require surgery. The size and depth of the patient’s wound will determine if they need surgery and which surgery is most appropriate. The majority of burn surgery procedures are skin grafts and reconstructive procedures.
It may take several days for the doctor to know if the patient needs surgery. If you do need surgery the University of Utah Health Burn Center has a state-of-the-art operating room on our unit. Here is a brief guide to the different types of surgical procedures patients may need.
Burn Surgery Procedures
Escharotomy – A cut made in the burn to relieve pressure and help blood flow return to the area. This is the type of procedure used to treat circumferential burns and compartment syndrome.
Fasciotomy – A cut made in the fascia to relieve pressure and increase blood flow. This type of operation is often used to treat severe circumferential burns and compartment syndrome.
Release – A surgical procedure which releases the scar tissue and allows for better range of motion and function. A release may require the addition of a skin graft.
Tracheostomy – A cut made by a surgeon into the neck that allows a tube to be placed into the lungs which will help the patient breathe.
Amputation — In some extreme cases a patient may need amputation or the removal of a body part. Your burn care team will work closely with you through this process if necessary. Amputees can lead healthy, fulfilling lives.
Flap Reconstruction
Flaps are a full thickness section of skin that is surgically removed from one part of the body and transferred to another part of the body.
Skin Grafts for Burns
A graft is skin that is surgically placed on a deeply burned area or to cover an open wound. Types of grafts include:
Allograft – A skin graft taken from the skin bank (cadaver skin) and placed on a patient’s burn to help it heal. This is not a permanent graft.
Autograft – A thin layer of donor skin taken from an unburned part of the patient’s body and placed on the burned part of the body. This is a permanent graft.
Mesh Graft – A skin graft that is meshed by putting it through a special machine. This meshing allows the skin graft to be stretched in order to cover a larger area.
Split Thickness Auto Graft (STAG) – A thin layer of donor skin from an unburned part of the body that is meshed (stretched) to cover a larger area. The meshing creates a pattern of small slits in the skin, which creates a better bond to the burned skin.
Sheet Grafts – A thin layer of donor skin that is not meshed and does not have the pattern that meshed donors have. These grafts produce a smooth appearance and are typically placed on hands and faces. Sheet grafts take longer to heal and require the patient to have restricted movement and activity during the healing process.
Burn Surgery Team
The burn surgery team consists of a:
- burn surgeon,
- general surgery resident,
- burn APC (advanced practice clinician,
- anesthesia,
- OR (operating room) scrub tech,
- OR nurse, and an
- OR HCA (health care assistant).
Meet Our Burn Surgery Team
Preparing for Surgery
If the provider decides a patient needs surgery, they will explain the procedure to you. They will also need written consent from you to perform surgery.
Before Surgery
Patients will not be allowed to have anything to eat or drink after midnight on the day of surgery. Before surgery, the anesthesiologist and the operating room nurse will talk to the patient and family to answer questions and review the procedure. The patient will then be taken to the operating room. A child life specialist is often available to escort pediatric patients to the operating room. The length of surgery depends on the extent of the burn injury and the surgical plan.
Family can wait in the burn center waiting room.
After Surgery
After surgery, the care team will take the patient back to the burn unit or recovery area. The nurse will assess when visitors are allowed into the patient room. Patients often experience pain after surgery. Your care team will work together to manage your pain.
Your dressings are not typically changed for three to five days after surgery. The dressings may be bulky and often splinted to protect the new graft. You may be required to keep the grafted body part still for several days. This may mean you will be on bed rest, however, your medical team will work with you to determine an appropriate level of activity after surgery.
Staples holding the graft in place are removed within a week of the procedure. Wound care and activity level will be adjusted based on your individual needs.
Resources for Our Patients
Verified Burn Center Experts
Why does it matter that we are a verified burn center? The American Burn Association and the American College of Surgeons designed a rigorous review program that ensures verified centers offer the best care for their patients. This includes the whole patient experience from the time of injury through rehabilitation.
It also means we meet the highest quality of care available because we meet these high quality standards. The standards are for personnel qualifications, facilities resources, organizational structure, and medical care services.
