Split-thickness Skin Grafting

WHAT YOU SHOULD KNOW:

• Split-thickness skin grafting (STSG) is surgery to cover and repair areas of skin loss or defect. It is commonly used to repair large but not too deep skin ulcers, diabetic or traumatic wounds, and burns. STSG uses the epidermis and some parts of the dermis (skin layers) taken from one area of the body and transplanted to another area. The area where the normal skin will be taken is called the donor site. Your caregiver may take the donor skin from your thighs, groin, lower leg, upper arm, or inner forearm.
  
  
• During surgery, a wound pattern is made and traced on the donor site. The graft is taken from the donor site just like peeling a potato skin. It may be done using a surgical blade or a special peeler-like device called a dermatome. Small holes may be made on the donor skin to make it bigger before placing it over the wound. Bandages and pressure dressings are placed to cover the graft and donor sites. Repairing your wound or damaged skin using STSG may help it to heal, and improve its appearance.

INSTRUCTIONS:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Ask your caregiver when you should return to have your wound checked, or stitches removed.

Rest: You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed.

Wound care: The graft and donor site must remain free from germs, such as bacteria and viruses, in order for healing to happen. Certain factors may cause graft failure and delay wound healing. Do the following to help your wounds heal:

• Avoid smoking cigars, pipes and cigarettes. Smoking may affect the formation of new blood vessels on the graft and wound site.
  
  
• Certain medicines, such as steroids and blood thinners, may delay wound healing. Ask your caregiver for more information about medicines that may cause a delay in wound healing.
  
  
• Do not let your wounds get wet. Always keep your wounds clean and dry. When you are allowed to bathe or shower, carefully wash the graft and donor sites with soap and water. Afterwards, put on clean, new bandages. Change your bandages every time they get wet or dirty. Ask your caregiver for more information about wound care.
  
  
• If you have certain diseases, such as diabetes (high blood sugar), take your medicines regularly and carefully control your blood sugar. People with diabetes may have poor wound healing. Ask your caregiver for help in managing your diabetes.
  
  
• Limit movements such as stretching, to prevent bleeding, shearing, and swelling in the wound and grafted sites.
  
  
• Protect the graft site from direct sunlight for at least six months to avoid burning of the skin. If it appears dry and scaly, keep it moist by applying lotion to it. Ask your caregiver for the type of lotion you may need to use on your skin.
  
  
• Taking vitamins and eating healthy foods high in protein may improve wound healing. Poultry, meat, dairy products such as eggs and cheese are high in protein. Ask your caregiver if you should use vitamins, and for more information about a high-protein diet.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• Your bandage becomes soaked with blood.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your surgery, or medicine.

SEEK CARE IMMEDIATELY IF:

• You feel something is bulging out from your graft site and not going back in.
  
  
• You have more pain in the area where the graft was made.
  
  
• You have trouble breathing all of a sudden.
  
  
• Your graft site or donor site has blood, pus, or a foul-smelling odor.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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