WHAT YOU NEED TO KNOW:

What is skin grafting? Skin grafting is surgery to cover and repair wounds with a skin graft. A skin graft is a portion of healthy skin that is taken from another area of your body called the donor site. Substitute skin grafts may also be used. These grafts may be artificial or they may come from another person or animal, such as a pig. Substitute skin grafts may be used only as temporary covers when large areas of the skin are damaged. They are replaced with your own skin over time.

What are the types of skin grafts?

• Full-thickness: 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: 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.

Where does a skin graft come from? Your graft may be taken from your legs, arms, back, abdomen, ear, eyelid, or scalp. The skin's color, texture (smoothness), hair growth, and thickness are considered in the donor area choice. The skin may be taken from an area near the injury to match the area where the graft will be placed.

What are the risks of skin grafting?

• The grafted skin may die, and you may need another graft. The grafted skin may not look or feel the way you expected. The skin may contract (shrink) or change color. Scars may form on the graft and donor sites. You may bleed more than expected or get an infection. Bleeding or infection under the graft may slow or prevent wound healing. You could have trouble breathing or get blood clots.
  
  
• You may have continued pain or swelling after the surgery. Certain diseases or conditions may slow the healing process. Some examples are diabetes, blood vessel problems, and liver, kidney, lung, or heart conditions. Poor nutrition or a weak immune system may also cause problems with healing.

What should I expect after skin grafting?

• Medicines: You may need to take medicines to decrease pain or severe itching, or to fight infection. Do not take any medicine that has aspirin or blood thinners in it. These medicines may make you more likely to bleed. Take your regular medicines as directed by your healthcare provider.
  
  
• Bandages: After surgery, a bandage will be put on the graft site to hold the graft in place. Do not remove the bandage yourself. Your healthcare provider will arrange for the bandage to be removed or changed after a few days. Keep the bandage clean and dry.
  
  
• Wound care: Do not rub or scratch the donor and graft sites. Protect your wounds from direct sunlight.
  
  
• Changes in activity: You may need to avoid certain activities, such as exercise or lifting heavy objects. You may also need to avoid activities that can irritate your wounds. Ask your healthcare provider which activities you should avoid or limit.
  
  
• Elevate: Elevate your arm or leg if you have a graft or donor site there. Prop your arm or leg on pillows to raise the area above your heart as often as you can. This will help decrease swelling.
  
  
• Follow-up visits: You will need to follow up with your healthcare provider regularly to have your sutures removed, bandages changed, and wounds checked. Any fluid that has collected in the graft site will be removed.

When should I contact my healthcare provider? Contact your healthcare provider if:

• You have increased swelling and redness in or around your wound.
  
  
• You have muscle, joint, or body aches, sweating, chills, or a fever.
  
  
• You have pain that worsens or does not go away after you take pain medicine.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care? See care immediately or call 911 if:

• You feel something is bulging out from your graft site and not going back in.
  
  
• You have pus or a foul odor coming from your wound.
  
  
• Blood soaks through your bandage.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.