Patients with partial or full thickness burns second- , third- , and fourth-degree burns generally need skin grafts to help close the wounds and prevent infection. Burn injury skin graft surgery can help patients heal faster, reduce their length of time in the hospital, and improve the appearance of the burned skin. Prior to performing skin graft surgery, the doctors will remove the dead skin around the burn site, a process called debridement. Doctors usually use the buttocks and thighs as donor sites. Surgeons use a dermatome a tool that cuts tissue into thin slices to shave off a thin layer of healthy skin and apply it to the burn site.
Types of Skin Graft
A skin graft is a surgical procedure which involves transplanting skin. Skin graft operations are performed when burn victims experience severe burn injuries that cause death or permanent damage of the skin. The location of the healthy skin is referred to as a donor site. The selected donor site is typically an area hidden by clothing, such as the inner thigh or buttocks. Patients typically select these areas to reduce scar visibility to others. Before the skin graft is performed, the patient will be placed under general anesthesia. Once removed, the skin from the donor site is spread onto the area where it is to be transplanted.
A first degree or superficial burn heals naturally because your body is able to replace damaged skin cells. Deep second and full-thickness burns require skin graft surgery for quick healing and minimal scarring. In the case of large burn size, patients will need more than one operation during a hospital stay. To help the graft heal and become secure, the area of the graft is not moved for five days following each surgery. During this immobilization period, blood vessels begin to grow from the tissue below into the donor skin, bonding the two layers together. Five days after grafting, exercise therapy programs, tub baths and other normal daily activities resume. There are a variety of skin grafts, some that provide temporary cover and others that are for permanent wound coverage.
Skin grafts are used to treat partial thickness and full thickness burns. Early surgical removal excision or debridement of burned skin followed by skin grafting reduces the number of days in the hospital and usually improves the function and appearance of the burned area, especially when the face, hands, or feet are involved. The grafts called autografts will ideally come from locations that are not ordinarily visible, such as the buttocks or upper thighs, because the donor sites will not be normal in appearance after they heal. However, the size of grafts that are needed and the location of burns will also determine where the grafts are taken from. An instrument called a power dermatome is set to a particular depth and shaves off a uniform layer of healthy skin to graft onto a burned site. The thickness of the skin graft depends on the area needing the graft. The donor site for a split thickness graft does not need to be surgically closed and will ordinarily form a new top layer of skin in 10 to 14 days.