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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.
AFTER YOU LEAVE:
Take your medicine as directed:
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
Ask your caregiver when you should return to have your wound checked or stitches removed.
Rest when you need to while you heal after surgery.
Slowly start to do more each day. Return to your daily activities as directed.
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.
- 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.
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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.