Transplantation Technology

In split skin transplantation, the donor skin area is removed under sterile surgical conditions using a dermatome or Humby knife and, if necessary, reworked by making a mesh-like incision and enlarging its surface. The donor site is cleaned and treated with haemostatic substances that contract the wound and sterilely bandaged. The graft is applied to the recipient wound and fixed with tissue adhesive, staples or small sutures.

Full-thickness skin grafts are also removed under the same sterile operating conditions, but the classic scalpel is used for this purpose and the removal site is marked beforehand using a template. Once the full skin has been removed, it is completely degreased and, if necessary, the scalpel is used to make several surface incisions to achieve better growth later. The donor site is sutured and covered with a sterile compression bandage for approx.

5 days. The application of the graft is similar to that of the split skin transplant. When removing both full skin and split skin grafts, the plastic surgeon makes sure that the direction of the incision corresponds to the course of the skin tension lines in order to ensure correct scar formation.

Furthermore, the surgeon makes sure that the graft is incised at various points and is not too tightly fixed and placed under tension, so that the drainage of wound secretion is possible during the course of the procedure. Depending on the size of the donor site and the wound to be covered, the surgical procedures are performed under local or general anesthesia. To ensure optimum healing of the graft, the affected body area/extremity should be immobilized for 6-8 days in the first few days and regularly treated with slightly compressive bandages.

Usually plaster casts or splints are used for this purpose. Within approx. 10 days the graft should have grown firmly through newly formed tissue and be connected to the blood supply system of the surrounding healthy skin so that sufficient blood circulation of the graft is ensured.

This is made possible primarily by the release of the skin’s own growth factors. In some cases, swelling may occur in the affected area within the first 2-4 days (edema formation due to water retention or storage of wound secretions). The color of the graft changes with the blood circulation.

It is pale at the beginning, reddish after 3-4 days, then red after about 1 week and finally returns to normal skin color after about 2 weeks. This is also approximately the time at which hair growth in the transplantation area begins again (approx. after 2-3 weeks). In order to optimize scar formation and keep the less elastic scar tissue supple, care with fatty ointments can also help. Movement restricting scar formation should also be counteracted by exercise to stretch the scar tissue, which should be started as soon as possible after the graft has grown safely.