Skin grafting is used in burns, chemical burns, or ulcers to cover damaged skin. The skin used comes from the same patient. It is usually taken from the thigh, abdomen, or back. The goal is to treat wounds that do not heal through conservative measures because of their size.
What is skin grafting?
Skin grafting is the most commonly used procedure in plastic surgery. Skin grafting is used in burns, burns or ulcers to cover damaged skin. Skin grafting is the most commonly used procedure in plastic surgery. In order for the wound to be treated in this way, it must be free of all bacteria and other pathogens, and skin areas suitable for transplantation must be available. The prerequisite is healthy tissue. Numerous operations have shown that the result is perceived most aesthetically when the transplanted skin is as close as possible to the actual injury. If surgeries and other medications cannot make the wound heal, skin transplantation must be performed within a short window of time. In this way, the development of infections can be prevented. Normally, the body is capable of healing all damage to the skin on its own. However, once the wound reaches a certain size, it is a process that takes a long time and is susceptible to bacteria. The skin itself represents an important part of the human body. On the one hand, it is the largest organ, on the other hand, it protects the organism from heat, dirt and pressure.
Function, effect and goals
Different methods exist for transplantation of skin areas. Full-thickness skin transplants as well as split-thickness skin transplants are used particularly frequently. Both initially rely on donor tissue from the same person who has an extensive injury. If this person does not have any healthy skin areas, however, cells from other people can also be transplanted. In such a case, these are foreign skin grafts. At the latest, when 70 percent of the skin surface is damaged, it is no longer possible to harvest one’s own skin areas. The skin has several layers: Upper skin (epidermis), dermis and lower skin (subcutis). In a full skin transplant, doctors remove the epidermis and dermis. The skin appendages remain intact. These are, for example, hair follicles and sweat glands. Compared to split skin transplantation, areas are removed that are relatively thick. After the tissue is removed, the wound must be closed. In most cases, a suture is used for this purpose. The healing of the removal area often results in scarring. It is not suitable for further skin transplantation after the first removal. Full-thickness skin grafts are used especially for wounds that are small and deep. The result is perceived as better than that of a split skin graft, both aesthetically and functionally. Split thickness skin graft is limited to epidermis and upper dermis. Their thickness is approximately 0.25 to 0.5 millimeters. In case of split skin grafting, the region of removal usually heals within 2 to 3 weeks. At the same time the same area can serve several operations, no scar develops in the further healing process. While full-thickness skin transplantation is suitable only for wounds that are free of bacteria and well supplied with blood, the existence of such conditions is not obligatory for split-thickness skin transplantation. Another method is the cultivation of the patient’s own skin. Some cells are taken from the patient. On this basis, a skin flap can be grown in a laboratory. Such a procedure takes about 2 to 3 weeks and can therefore not be used for acute accidents that require quick action. During the operation itself, the healthy skin area is fixed with the help of staples, sutures or fibrin glue. In order for the wound secretion to drain, the tissue must be cut in some places. The operation is completed with the application of a compression bandage and immobilization. This is particularly important to allow the skin to fuse properly.
Risks, side effects and dangers
Transplants that are recipient-derived have no risk of rejection. Nevertheless, some risks exist that must be considered. For example, after surgery, bacteria or other pathogens can accumulate in the area of the freshly sutured site and cause infection. Infections can occur with autologous skin transplants as well as with foreign skin transplants. During or after surgery, onset of bleeding cannot be ruled out. In addition, disturbances of healing or delayed growth may occur. These usually develop if the wound was not sufficiently supplied with blood during the operation. If the attending physician has not applied or sutured the graft optimally, further growth delays may result because the contact between skin and graft may be interrupted. After healing is complete, the occurrence of numbness in the transplanted area cannot be ruled out. If an extensive transplantation was performed, the patient may possibly be restricted in his or her movement due to the scarring. Furthermore, the absence of hair growth can be observed in some cases. How high the individual risk is ultimately depends on several factors. These include, above all, the age of the patient as well as all secondary diseases and conditions that cause the wound to heal more or less well. Accordingly, the risk is particularly increased in people over 60 years of age and young children. Further caution should be exercised in diabetics, immune disorders, anemia, and chronic infections.
