Skin Grafting

Skin grafting is a type of surgery that involves transplanting skin from one area of the body to another. It can also be done through using skin from a  donor. Skin grafting is most commonly used to heal and cover extensive burned areas and large wounds. Skin grafts are also used when skin that was lost due to infection or skin cancer.

Costs

The cost of skin grafting surgery varies greatly depending on the scope of the graft and how extensive the surgery will be. It also depends if you have to get the procedure done in a hospital or if you can get it done at a clinic. The fees can range from $1,500- $10,000. The fee also depends on the doctor’s expertise, but there is a Healthcare Blue Book that will let you know of fair price information. The fees incurred with this procedure include anesthesia, consultations and medications. The cost of this procedure is sometimes covered by medical insurance depending on the nature of the skin graft.

Surgery

The surgery will begin with the removal of the damaged skin. The damaged area is then replaced with skin grafting. The grafting will improve not only the function of the affected area, but the appearance as well. There are two different types of skin grafts. The most common type is when a thin layer of skin is removed from a healthy part of the body (also known as the donor site). A full thickness skin graft is less common and more risky. This skin graft involves pitching and cutting skin away from the donor skin. It leaves only a small scar line on the donor section similar to a Cesarean section scar. The donor site will heal much quicker than a partial thickness graft. To remove the skin and preserve strips from the donor the surgeon will use a dermatome. It produces split thickness skin graft, which contains the epidermis with only a portion of the dermis. The dermis left at the donor site will contain hair follicles and sebaceous glands. It will also contain epidermal cells which will gradually proliferate to form a new layer of epidermis. The donor site will be painful and is extremely susceptible to infection. The skin graft is then carefully spread out on the bare area that needs to be covered. It is held in place with either stitches or surgical staples. The graft is initially nourished through plasmatic imbibition. This allows the graft to “drink plasma”. New blood vessels begin growing into the transplanted skin within 36 hours which is called capillary inosculation. In order to prevent the accumulation of fluid under the graft small rows of short cuts, each a few millimeters long are performed. This allows for drainage and for the graft to stretch and cover a larger area. It is common for doctors to aid in graft healing by using negative pressure wound therapy. This system works by placing a section of foam over the wound and then laying a tube onto the foam. It is secured with bandages. A vacuum unit seals the edges of the wound to foam. It also draws out excess blood and fluids. It helps to maintain the cleanliness of the site, promotes development of new blood vessels and increases the chance of the graft being successful.

Health Risks

There are many health risks involved with skin grafting surgery including bleeding, loss of grafted skin and infection. Serious complications include nerve damage and graft versus host disease. Rejection may also occur, which is why most patients are treated with immunosuppressant medications. Grafts that fail to heal may require a new graft.

Recovery

After receiving a skin graft the patient will be monitored to ensure good circulation. Recovery can be long, with the patient having to wear compression garments for several months. It is important to check regularly on the wound to ensure it is healing properly. Patients may have to wear a dressing for up to two weeks. Heavy exercise and stretching should be avoided for at least three weeks. Full thickness grafts require a longer stay in hospital, for approximately one to two weeks. Some people may require physical therapy after surgery.

Follow-up

The doctor will let the patient know what to expect for the following days, weeks and months after the procedure. It is important to follow the doctor’s instructions to have the graft take and heal properly. Most doctors will want to see how the graft is taking within a few weeks. If the patient experiences any symptoms that seem abnormal they should make sure to seek medical care right away.