During a split thickness skin graft, your surgeon will remove a thin layer of skin from 1 part of your body donor site and use it to close the. Contains 100% of the epidermis and a portion of the dermis. Discharge instructions for your split thickness skin graft site. Skin grafts, splitthickness and fullthickness woundsource. Fullthickness the harvested skin includes the epidermis the surface layer of the skin and all of the dermis. Technical guide technical guide what you need to know. In general, epithelial cells within epidermal appendages, such as hair follicles and sweat glands, regenerate a split thickness skin graft donor site within 721 days. About your split thickness skin graft this information describes surgery using a split thickness skin graft.
When a graft includes only a portion of the dermis, it is referred to as a split thickness skin graft stsg, whereas when the entire dermis is included it is called a fullthickness skin graft ftsg. A split thickness skin graft involves the epidermis and a little of the underlying dermis. Split thickness skin graft is often taken from the leg. A splitthickness graft involves removing the top layer of the skin the epidermis as well as a portion of the deeper layer. Split thickness skin grafts and complicated diabetic wounds. An allograft previ ously homograft is taken from another individual of the same species. A xenograft heterograft is a graft taken from an individual of one species that is grafted onto an individual of a different species. Split, or partialthickness, skin grafts are by far the most commonly used grafts in plastic surgery. Type of graft advantages disadvantages thin split thickness best survival heals rapidly least resembles original skin. Under no circumstances are you to attempt to remove the bolster on your own. Following preparation of the wound, the surgeon then harvests the tissue for grafting.
A skin graft is healthy skin that is used to replace damaged or missing skin. Split thickness skin graft an overview sciencedirect. Most people who are having a skin graft have a split thickness skin graft. Moisturizing your skin graft and skin graft donor site. The stsg is used to cover an area of skin that has been damaged or cannot heal because of an injury or abnormality. It is commonly used to repair large but not too deep skin ulcers, diabetic or traumatic wounds, and burns. Skin graft harvesting and donor site selection 21 wellknown type of mesher contains circular bl ades and requires the use of grooved plastic carriers figure 3. If you have any of the following symptoms, on the ward or at home, please. Skin grafts are used in a variety of clinical situations, such as traumatic wounds, defects after oncologic resection, burn reconstruction, scar contracture release, congenital skin deficiencies, hair restoration, vitiligo, and nippleareola reconstruction. It is used with a dual mesh in reconstruction of full thickness defects of anterior abdominal wall and covered by skin grafts. You may have a skin wound as a result of surgery to remove a lesion caused by skin cancer, a severe skin infection, or from an injury or burn. Although most of these wounds will heal with local care and with a reasonable functional result, split thickness skin grafting as a simple outpatient or bedside procedure can speed healing more comfortably for the patient and with greatly improved functional results.
Skin grafts and skin graft donor sites must be moisturized to lessen dryness, cracking, and itching. Skin grafts are generally classified as splitthickness or fullthickness grafts. Split thickness skin grafts can be taken from any area of the body, including the scalp fig. Case 7 91 year old female who presented to the office with a foulsmelling, bleeding, large basal cell carcinoma of the scalp. Burns which may heal without skin grafting would be dressed with a sterile dressing, a biosynthetic skin substitute, cultured skin, or skin allograft.
Split thickness skin graft generally this wound is from the thigh region 1. Split skin graft ssg a split skin graft ssg is where a very thin shaving of normal, healthy skin is used to cover an area of skin that has been damaged or cannot heal because of an injury e. Fullthickness skin grafts are done when a lot of tissue is lost. Healthy skin is taken from a place on your body called the donor site. The epidermis and part of the dermis are removed from the donor site and transplanted on the damaged area. Discharge instructions for your skin graft site saint.
Split skin grafts this is the top layer of skin epidermis. The advantages include the availability of a large donor site. Pdf skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Skin graft indications, procedure, aftercare and skin. A splitthickness graft involves removing the top layer of the skin the epidermis as well as a portion of the deeper layer of the skin, called the dermis. The two most common are split skin grafts and full thickness skin grafts. A very thin layer of skin a graft is taken from an area of your body normally covered by clothes, such as the thigh or buttock area. The halo split skin graft in the management of nonmelanoma skin cancer of the leg. With burn contracture releases and split thickness skin grafting, re contracture. Secondary contraction is greatest in split thickness grafts. The graft may be held in place by staples, stitches or surgical glue. If the area is small and the skin nearby is loose, the wound can. Splitthickness skin grafts involve only the epidermis and a small portion of the dermis, leaving behind enough of the dermis for the donor site to heal by reepithelialization.
Types of grafts 1 split or partial thickness graft thiersch grafts this is the most common type of graft. Skin grafts are classified as autograft, allograft homograft, xenograft heterograft and isograft syngenic according to the sources. A splitthickness skin graft, also known as a partialthickness skin graft, is a portion of skin that contains both epidermis and varying portions of the dermis. Information for patients skin cancer and split skin. When a graft includes only a portion of the dermis, it is called a split. If the thigh wound and the xeroform are still moist, dry the wound and the. Split thickness skin grafts and complicated diabetic wounds apma. Pdf scalp as a donor site for split thickness skin grafts.
Following irb approval, patients were screened for approval. Fullthickness skin grafts contain both the full epidermis and dermis. The technique of harvesting the split thickness skin grafts in this area requires the use of pitkins syringe and brown air dermatome. By using such an instrument the blades are forced under pressure to roll over the grooved carrier, thus cutting the graft at locations where the blades contact the carrier. Meshed skin grafts if a skin graft is passed through a meshing device made from two metal rollers, it will insert multiple fenestrations holes into the skin graft, allowing the. S diabetic patients without comorbidities have shown no significant difference in healing times compared to nondiabetic patients for stsg. It is common to have some drainage clear yellow or red in color from a split thickness skin graft site. Classification of splitthickness skin grafts skin grafts are classified according to origin and thickness. You can start putting moisturizer on your skin graft or donor site after it is fully healed. Ftsgs have limited donor sites and have less longterm contracture and scar formation. Superficial slices of skin the thickness of tissue paper are cut with a hand or mechanical razor. This type of skin graft is taken by shaving the layers of the skin. A split skin graft is often used after excision of a lesion on the lower leg.
Split thickness skin grafts s for both chronic and acute wounds, stsg offer a rapid and effective way to provide closure and healing. It is less painful than the alternate split thickness skin graft and tends to have a more natural and aesthetically pleasing end result. Split thickness or partial thickness skin graft stsgthis type of skin graft involves using the superficial layer i. Primary care physicians often see wounds in which skin loss is a major factor. The possg is a pedicled graft based on either the right or left gastroepiploic arteries. Split thickness grafts are further classified as thin or thick. His most concerning wound is his left posterior leg and achilles insertion region.
A split thickness skin graft stsg is a very thin shaving of normal skin taken from an undamaged area of the body. Stsg uses the epidermis and some parts of the dermis skin layers taken from one area of the body and transplanted to another area. This takes the two top layers of skin from the donor site the epidermis and the layer under the epidermis the dermis. B 5 days post tangential excision of the eschar and skin grafting. These patients presented to the plastic surgery service both inpatient and outpatient. Splitthickness grafts can survive in less ideal recipient sites with less vascularity, but the thinner the graft. Patients who were older than 17 years of age undergoing a split thickness skin graft were approached to participate in the study. The areas most commonly used as donor sites for skins grafts are leg, inner thigh, upper arm, forearm and. A fullthickness skin graft is composed of the epidermis and all of the dermis as well as.
A fullthickness skin graft is composed of the epidermis and all of the dermis as well as variable amounts of subcutaneous tissue. Information leaflet for patients with a split skin graft ssg to the leg why a skin graft. Skin grafts are classified as either stsgs, which contain only a portion of the dermis with the entire epidermis, or fullthickness skin graft ftsgs, which contain all skin layers, including some of the skin appendages. Patients undergoing a split skin graft as part of reconstructive surgery. Pdf the halo split skin graft in the management of non. The area where the skin is taken from is called a donor site. Healed grafts and donor sites are pink and dry, and do not have any drainage.
Splitthickness skin grafts have the epidermis and part of the dermis. A splitthickness skin graft stsg contains epi dermis and a variable amount of dermis. Split thickness skin grafts clinical practice standard. The surgeon first marks the outline of the wound on the skin of the donor site, enlarging it by 35% to allow. Fullthickness skin grafts do not contract as much as split skin grafts, so are used to cover exposed areas of the body, usually the face or neck. Full thickness skin graft ftsgthis type of skin grafts involves both the layers of the skin i. Splitthickness skin grafts remain the gold standard for. The shaved piece of skin is then applied to the wound. Skin grafts can be categorized as a split thickness graft or a fullthickness graft. The donor site of splitthickness skin grafts is covered with. Primary contraction, an elastic recoil of the skin caused by retractile forces, occurs as soon as the graft is harvested.
Skin cancer and split skin grafts st vincents hospital. Splitthickness skin grafting discharge care what you. An autograft is a graft transferred from a donor to recipient site in the same individual. The xeroform is the yellowcolor bandage that was applied to the thigh at the time of the surgery. However, not as much skin can be harvested and grafts are more likely to be rejected than with split thickness grafts. Split thickness skin grafting stsg is surgery to cover and repair areas of skin loss or defect. A thirddegree burn wound before split thickness skin graft. In those cases which were to have a control split thickness skin graft donor site area, fine mesh gauze was placed over onethird to onehalf of the donor site. You will need to care for both the graft and donor sites as instructed so they heal properly. Treatment of skin graft donor sites using 3m tegaderm. Graft contraction, graft failure, hyperpigmentation, itchiness and dryness of the graft, durability and growth problems are the most common complications of split thickness skin grafting. Several types of dressings can be used to heal donor sites for a split thickness skin graft.
436 614 89 1262 702 796 1370 1192 169 540 961 1176 283 861 1258 305 1073 937 886 658 793 1392 111 213 97 1382 195 1209 1149 167