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Full-thickness Skin Grafting
WHAT YOU SHOULD KNOW:
- Full-thickness skin grafting (FTSG) is surgery to treat non-healing wounds or burns, and repair damaged skin or scars. FTSG uses the dermis and epidermis (skin layers) taken from one area of the body and transplanted to another area. It is most commonly used to repair small facial skin defects resulting from removal of skin cancers. The area where the normal skin will be taken is called the donor site. Your caregiver may take the donor skin from the upper eyelid, or between the nose and lips. Skin around the ears, neck, above the collar bone, or even wrist and groin skin may also be used. The color, texture, and thickness of the donor site should match with those of the site being repaired. If the damage is severe (bad), your caregiver may even use the cartilage or ligaments under the donor skin.
- During surgery, a wound pattern is made with a gauze pad and traced over the skin of the donor site. The graft is taken from the donor site with a surgical knife. It is trimmed to the exact size and shape so it will perfectly fit the wound site. Both donor and wound sites are closed with sutures (threads) and covered with bandages and surgical dressings. These may help prevent bleeding and hematomas (swelling with blood). Repairing your wound or damaged skin using FTSG may help it to heal, and improve its appearance.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
There are always risks with surgery. You may bleed more than expected or get an infection. You could have trouble breathing or get blood clots. You could have an allergic reaction to an anesthesia medicine. Your caregivers will watch you closely for these problems. You may have continued pain or swelling after the surgery. Sometimes the surgery may not be successful and need to be done again. The grafted site may also not look or feel as you would have expected. If you do not have surgery, the pain or deformity you have with your wound may get worse. Call or ask your caregiver if you are worried or have more questions about your surgery.
WHILE YOU ARE HERE:
Before your surgery:
- Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
- IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
- Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
- Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
- Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
During your surgery:
- You are placed on a position where you and your caregiver doing the surgery would be both comfortable. Medicine called anesthesia is given to control pain during the surgery. A caregiver cleans and prepares the wound site and the donor site. Clean sheets are put over you to keep the surgery area clean.
- During your surgery, a wound pattern is made on a clean gauze pad. The pattern is traced over the skin of the donor site using a surgical marking pen. Your caregiver gets the graft by following the pattern done on the donor site. The donor site is cut out using a surgical knife. The graft is trimmed to the exact size and shape so it will perfectly fit the wound site. Fatty tissues are removed from the graft before it is placed over the wound site. Small slits are also made on the graft to prevent swelling and allow fluid to escape. Your caregiver then closes the wound and donor sites with sutures (threads) or surgical staples. Bandage and pressure dressings are placed covering the graft to prevent bleeding and hematomas (swelling with blood).
You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. If you had general anesthetic, an adult will need to drive you home. Your driver or someone else should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.
- Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.
- Medicines: You may be given the following medicines:
- Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
- Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
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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.