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Skin grafting is transplantation of skin from a healthy area to a wounded one. Grafting is used to treat extensive wounding or trauma, burns, areas where prior infections have made them lose skin, or specific surgeries which need skin grafts to heal. The damaged skin is surgically removed by excision and is replaced by skin grafting. A special surgical instrument called the dermatome is used to remove the skin slices from the donor. This skin graft contains the epidermis, while the hair follicles and sebaceous glands are left behind in the donor’s body to form a new layer of epidermis. This area may be very painful, red, and vulnerable to infection. Hence the donor also has to take great care.
The graft is spread over the area to be grafted, and tiny stitches are put to keep it in place. Plasmatic imbibitions takes place where the graft ‘drinks’ the plasma. New blood vessels start growing in the transplanted area within two days through a process called capillary inosculation.
Fluids may get accumulated in the area of the graft which may be a barrier to its attachment. And to prevent this, the graft is frequently meshed by making cuts. This drains of the fluids and also allows the graft to stretch and cover a larger area which can fit into the contours of the recipient area.
Vacuum Assisted Closure (VAC) is a technique which helps preoperative wound maintenance and postoperative graft healing. This is done by laying a piece of foam on the wound and covering it with a perforated tube which is then secured by bandages. A vacuum unit seals off the ends and removes excess fluids from the area. VAC keeps the graft area clean, helps new blood vessels to develop and increases the chances of the success of the graft. VAC can also be used to keep the infected wound clean till the graft is done.
The donor skin can be taken from the patient himself or from an external donor. One has to be careful that the skin types match if an external donor’s skin is used for grafting. Sometimes an animal’s skin may also be used to tide over the crisis till the patient’s own skin is formed or till a donor skin is obtained. This animal skin will prevent exposure of the wound and retain the important fluids in it. The skin of a dead person may also be used in a living person if it is absolutely necessary at that time. |
