Skin Graft: Purpose, Benefits, & Recovery

A skin graft is a surgical procedure in which a surgeon takes healthy skin from one part of the body (called the donor site) and transplants it to an area (called the graft site) where the skin is damaged or missing.

Please continue reading to learn more about skin graft surgery, including why it’s done, the benefits, and what to expect during recovery from skin grafting.

Why are skin grafts performed?

Skin grafts are performed to treat damaged or missing skin due to burns, injuries, infections, or diseases.

For example, people who have had skin cancer removed may require skin grafts. Skin grafting is also done to cover very large wounds and exposed bone as part of burn surgery and to treat diabetic ulcers and pressure injuries such as bedsores.

The main benefit of a skin graft is that it replaces lost or damaged skin with healthy skin, thereby restoring function and improving appearance.

Does skin grow back after a skin graft?

After a skin grafting procedure, the transplanted skin cells start to develop new blood vessels and connect to the surrounding skin within a few days. In most skin grafts, the new blood supply ensures that the grafted skin heals well and connects to the surrounding tissue, including the underlying muscle and subcutaneous fat. However, sometimes, the graft healing in the wound bed does not go as planned, and the grafted skin does not “take.” This is called a graft failure, and it may require another skin graft.

What are the different types of skin grafts?

Most skin grafts are taken from your own body (these are called autografts). If there isn’t enough healthy skin available, doctors may use skin substitutes from a cadaver (allograft) or pig (xenograft). This is a temporary measure until your wound heals or you grow enough healthy skin for a permanent skin graft.

Sometimes, composite grafts of skin and other soft tissues, such as underlying cartilage, are performed for improved graft survival and a better cosmetic outcome. For example, a composite graft may be done to repair skin on the nasal tip, ears, or fingertips.

The two main types of skin graft are split-thickness grafts and full-thickness skin grafts.

Split-thickness skin graft

Split-thickness skin grafts, also called partial-thickness skin grafts, are the more common type. In a split-thickness graft, only a thin layer of skin is transplanted, consisting of the upper layer (epidermis) and a part of the second layer (dermis). For instance, a small split-thickness graft called a pinch graft can be used to treat persistent skin ulcers.

The donor site for healthy skin in split-thickness grafts is usually an area of the body that is hidden under clothes, such as the buttocks, inner thigh, outer thigh, hip, belly, or back.

Full-thickness skin graft

A full-thickness graft is used to repair deeper tissue loss or damaged skin in a part of the body that you don’t usually cover with clothes, such as the face. During a full-thickness skin graft, the top layer (epidermis) and the entire thickness of the second layer (dermis) are transplanted.

The donor site for full-thickness grafts is usually the upper arm, collarbone, or groin.

What happens during a skin graft surgery?

After you are put under anesthesia, the surgeon will remove healthy skin from a predetermined area of the body (the donor site) by making incisions (cuts). They will then make small crisscrossed cuts or holes in the healthy skin (this is called meshing) so that it looks like a fishnet. Meshing allows the healthy skin to be stretched over a larger area and also promotes better healing and survival of the graft after the surgery. The transplanted skin is then secured to the graft site with stitches or staples. A dressing is placed over both areas.

Is a skin graft a serious surgery?

Yes, a skin graft is a serious dermatologic surgery. It involves surgical removal of healthy skin from a donor site and skin transplantation to an area of missing or damaged skin. This means there are two surgical sites (the donor site and the graft site) after a skin grafting procedure. Both surgical sites need to be monitored to ensure they heal properly.

How long is a hospital stay after a skin graft surgery?

You may be able to go home the same day after smaller skin grafts. Larger skin grafts may require a hospital stay of up to 2 weeks.

How painful is skin grafting?

A skin graft is usually done under general anesthesia. This means you are asleep and completely pain-free during the surgery. Smaller skin grafts may be done under local anesthesia.

After the surgery, there can be some soreness for 1-2 weeks during the healing process. Severe pain is unlikely, but your healthcare provider will prescribe pain medication to manage any discomfort.

How long does a skin graft take to heal?

The amount of time it takes for a skin graft to heal depends on many factors, such as the size, location, and type of skin graft. If you have a split-thickness skin graft, the donor site heals typically in 1-2 weeks. The donor skin at the graft site takes longer to heal. A full-thickness skin graft takes more time to heal than a split-thickness skin graft.

Does skin sensation return after a graft?

Sensation returns through regeneration of nerve endings at the graft site. Pain is usually the first sensation to return, followed by touch and temperature sensations.

What should you not do after a skin graft?

Don’t leave the wounds open. Wear a dressing as advised by your plastic surgery or reconstructive surgery provider. They will tell you how long you need to wear the dressing, how often to change it, and what to do if it gets wet. Use the antibiotic cream and other medicines, including pain medications and anti-inflammatories, as prescribed.
Avoid strenuous physical activity for 3-4 weeks. This can stretch the skin and damage the skin graft.
Don’t miss your follow-up visits. Your surgeon will want to monitor your skin graft and make sure it is healing properly. They may prescribe physical therapy to improve skin elasticity and prevent scar tissue formation at the graft site.

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