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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.
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 another grafting may need to be done. A skin graft may also contract (shrink) and not fully cover the wound. The grafted site may also not look and feel as you would have expected.
- If you do not have surgery, the pain and problems you have with your wound may get worse. You may carry the burden of having a bad looking wound appearance. 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 in a position where you and your caregiver doing the surgery would both be comfortable. Medicine called anesthesia is given to control pain during the surgery. A caregiver cleans and prepares the wound and donor sites. Clean sheets are put over you to keep the surgery area clean.
- During your surgery, the wound is measured and drawn on the donor site with a surgical marking pen. The graft is taken using a dermatome set or a razor blade lubricated with oil. The graft is meshed on a machine or slits are made on it using a surgical knife. The wound is coated with a special medicine to promote healing before the graft is placed over it. Once the graft is in place, it is attached with stitches (threads) or surgical staples. Bandages and pressure dressings with special medicines are used to cover both donor and wound sites.
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.