What Is a Skin Graft?
A skin graft is a patch of skin removed from one area of your body (donor site) and reattached in another place (recipient site). Skin grafts can only come from your own body. You can’t receive a skin graft from another person. Even a close relative can’t donate their skin because the DNA must be an exact match for your graft to be successful.
At University of Utah Health, we perform all types of skin grafts in our Burn Unit, General Surgery, and Plastic and Reconstructive Surgery departments. Our providers are highly qualified to treat wounds or scars with skin grafts to ensure the best possible outcomes.
How Do Skin Grafts Work?
A skin graft does not carry its own blood supply with it when moved to the recipient site. Skin grafts are used to treat wounds where only the skin is missing. All the structures below the skin must be intact. Skin grafts are similar to skin flaps, but the two procedures are different.
Who Needs a Skin Graft?
You might need a skin graft for many reasons:
- Skin cancer
- Tumor removal
- Covering up a scar
- Infections
- Large wounds
- Injury
- Severe burns
Skin grafts for burns are handled in our Burn Unit.
Types of Skin Grafts
Your surgeon will choose the best skin graft procedure based on your condition and size of the area that needs to be covered.
Split-Thickness Skin Graft
This type of graft treats burns or surface wounds. The top two layers of your skin will be removed from the donor site and placed on the recipient site. A large piece can be removed because the donor site can heal itself.
Split-thickness skin grafts often get used on parts of your body typically covered with clothing. The healed graft might not look as cosmetically pleasing as a full-thickness graft.
Full-Thickness Skin Graft
These skin grafts cover wounds that are deep or large and can’t be closed with stitches. A full-thickness skin graft takes all the layers of your skin (not just the top two) from the donor site and reattaches them at the recipient site. Only a smaller piece gets removed because the donor site must be stitched together to heal.
This skin graft is more durable and usually has a better cosmetic appearance. You might get this type if you need a wound or scar covered on your face or the palm of your hand.
Artificial Skin Graft
An artificial skin graft only partially heals your wound. The man-made skin (artificial dermis) is applied to your wound. Your artificial skin graft will get checked four weeks later to see if it developed its own blood supply. If it does, your surgeon will then apply a split-thickness skin graft on top of it to complete the artificial skin graft. There is currently no artificial skin graft that can fully replace natural skin grafts.
This method works best if your wound is narrow and deep. A skin flap or full-thickness skin graft are more extensive procedures used on deep wounds. However, a split-thickness skin graft won’t work on wounds with an exposed tendon or bone. Artificial skin grafts are less invasive but fully heal your wound.
Skin Graft Surgery
Your surgery will take two to three hours depending on how large the area is and what type of skin graft you get.
During your surgery, your surgeon will remove a thin section of skin from the donor site. The skin graft will be transferred to the recipient site and held in place using stitches, staples, or glue. Or, the graft may be laid over the recipient site. Your surgeon will firmly place sterile gauze and wound dressing over the surgical site to hold the graft in place. This allows your skin graft to attach to its new location and develop a new blood supply, which is important to the overall success of your graft.
After your surgery, you’ll have a wound dressing placed over the surgical site. This will be left in place for three to five days, then checked and replaced by a nurse or your surgeon at a follow-up appointment.
Skin Graft Aftercare
It’s important to care for your skin graft correctly after surgery. To ensure it heals right, you should:
- restrict movement of the area,
- leave your wound dressing in place and keep it dry, and
- wear loose-fitting clothing.
Rest is crucial so the graft can develop a healthy blood supply at the recipient site. After four weeks, your surgeon will remove the dressing at a follow-up appointment.
What Not to Do after Skin Graft Surgery
It’s important to avoid certain activities while your skin graft heals.
- Do not submerge your skin graft in a bath for two weeks.
- Do not get the area wet while showering.
- Do not engage in physical activity.
- Do not apply hot or cold compresses to the area.
- Do not remove the wound dressing at home.
Skin Graft Scars
Skin graft surgery results in two scars: one at the donor site and one at the recipient site. Your scar will have a slightly raised grid-like appearance at first. It will change to a more uneven, natural look as the wound heals.
Full-thickness skin graft scars are usually thicker because they involve a larger piece of skin. You can minimize the appearance of scars from skin graft surgery by:
- staying hydrated,
- avoiding direct sunlight on the scar,
- applying a scar-fading cream after the wounds have healed, and
- getting plastic surgery at a later time.
Skin Graft Failure
Your skin graft should develop its own blood supply within one to two weeks after surgery. Skin graft failures occur when the graft does not form a blood supply. If this happens, your skin graft will need to be redone.
Skin Graft Failure Symptoms
If your skin graft fails to successfully reattach and grow at the recipient site, you most likely won’t know until your follow-up appointment. When your surgeon removes the dressing and examines your skin graft, they will be able to tell you if it’s successful or failing. The main symptom is a gray color.
It’s important to follow your surgeon’s instructions during the recovery period. This will help prevent skin graft failure or complications. Most skin grafts are successful.
Skin Graft Complications
You might notice other symptoms of complications during your recovery. These include:
- wound swelling,
- redness spreading around the dressing,
- discoloration around the dressing,
- continuous pain, and
- fever.
Call your surgeon right away if you notice your skin graft isn’t healing correctly.
Find a Skin Graft Specialist
Make an Appointment for Skin Grafting
To make an appointment with a skin graft specialist at U of U Health, call the Plastic Surgery and Reconstructive department at 801-581-7719. In most cases, your provider will refer you to U of U Health as part of your treatment plan well before your surgery. If you’re having skin cancer removed or developing a plan to cover an old scar, your provider can also send in a referral for you.
Insurance Coverage for Skin Grafts
Since skin grafts always have a medically necessary reason, they are covered by insurance policies.