Skin Grafting

The recent years have witnessed many great progresses in the field of artificial skin replacement products. Even though, no artificial skin products can replace the patient’s own natural skin, but these products are highly in use owing to the limitation of available skin for allografting in severely burned patients. Unlike allographs and xenographs, the patient’s body does not reject the artificial skin replacements. The body actually encourages the new tissue generation. An artificial skin is mainly composed of a collagen-based dermis and a synthetic epidermis.

Skin grafting is a type of graft surgery. In this procedure, skin or a skin substitute is positioned over a burned or non-healing wound. A skin graft may either be used to permanently replace the damaged or missing skin, or sometimes to serve as a temporary wound covering. Skin is the outer covering, which preserves the body from fluid loss, assists in temperature regulation, and limits the entry of disease-causing bacteria or viruses from entering the body. The extensive burns or non-healing wounds on the body severely affects the health and well-being of the patient. The first- or second-degree burns, which usually heals with no scarring, does not require skin grafting. Skin grafting helps in preventing infection and further wound progressions, such as venous ulcers, diabetic ulcers, pressure sores, deep lacerations and Full Thickness Burns. In order to avoid a patchy appearance, it is essential to match the colour of the skin from the donor site with that of the recipient site.

Skin graft refers to the transplanted tissue. Skin grafting is often recommended for treating extensive wounds, burns or trauma. This procedure is greatly opted in the healing period of specific surgeries such as removal of skin cancers. The skin grafting procedure follows the surgical removal of the damaged skin. The duration of the treatment needed is reduced by grafting procedure. The appearance and function of the body area receiving skin graft are also improved. Skin grafts are mainly of two types. A thin layer removed from a healthy part of the body is the most common type. The other type is a full thickness skin graft, which the body may sometimes reject.

Skin Flap Grafting mainly tends to repair large wounds and defects. During the procedure, the skin, underlying muscle and tissues from the area near to the wound, are dissected out and freed. Later, for the purpose of filling the defects and replacing the lost tissue, the Skin Flap Grafts are rotated and stitched over the wound.

An important thing to remember is that even after the healing procedure of skin graft is over, it should be carefully maintained. To decrease the amount of contraction, the grafts on other body areas should also be equally supported. Oil glands or sweat is not present in the grafted skin. Mineral oil or any other bland oil should be used to lubricate the grafted skin in every two or three months. This helps to prevent drying and cracking of the skin. In case of severe burns, post surgery care includes psychological or psychiatric counselling, wound care and physical rehabilitation. Apart from severe pain and lengthy recovery period, the burn treatment procedure involves anxiety and depression.

Although, most cases of skin grafting procedure are successful, but in some people, the healing may not occur properly and requires repeat grafting. The success or failure of Skin Flap Grafting procedure depends upon several factors. Some of the are: Donor site, recipient site, graft vascularity, etc. The success procedure or the overall health may also be affected due to medical conditions like hypertension, diabetes, previous surgery scarring or past injuries.

Complications of the skin graft surgery are: Infection, loss of grafted skin, bleeding, nerve damage or graft-versus-host disease. The allograft procedure is accompanied with risk of transmission of an infectious disease from the donor. For preventing later infection, which can affect the graft result, the grafting tissue and the recipient site must be kept sterile. Graft failure mainly occurs due to the formation of hematoma, or blood collection in the injured tissues.

A doctor’s office or a hospital emergency room is chosen as a place for treating patients with less severe burns. The necessary procedures are performed by a surgical team that specializes in burn treatment and skin grafts. The team includes ophthalmologists, neurosurgeons, thoracic surgeons, oral surgeons, psychiatrists, plastic surgeons, trauma specialists and dermatologists. 

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