Skin Grafting: Types, Procedure And Complications
Skin grafting or skin transplant is a medical procedure that involves
the transplantation of skin. The transplanted tissue is called a skin
graft. The procedure comprises removing the skin from one part of the
body and transplanting it to another part in the body .
A skin graft is done when an individual has lost the protective
covering of skin due to an injury, burns or illness. It is commonly used
to treat extensive skin loss due to skin cancers or infections such as
necrotizing fasciitis or purpura fulminans.
The
part of the body from where the skin will be taken is known as the
donor site, which is mostly the buttocks and thighs. The healthy skin
from the donor site is placed into the wounded area so a to reduce the
long-term treatments and to improve the appearance and function of the
area being treated. The surgery will be done in a hospital, using
general anaesthesia so that the person undergoing the procedure does not
feel any pain or discomfort.
Types Of Skin Graft
The
three basic types of the medical procedure are categorised in
accordance with the nature and thickness of the skin removed. However,
before getting to know about the different types of skin grafting, it is
necessary to gather knowledge on the common types of skin grafts . That is, the donor site from where the skin has been extracted from
and an individual's experience with skin grafting is asserted to be
varied, depending on the type of graft received .
- Autograft: It is also known as an autologous graft, in which the donor skin comes from a different site on the individual's body. It is considered to be the most successful due to the genetic match in the skin.
- Allogeneic graft: The skin will be taken from another person.
- Isogeneic graft: The recipient and the donor will be genetically identical (identical twins).
- Xenograft: Also termed as xenogeneic, the donor and the recipient will be of different species. Mostly for this, pigs are used and the grafts are temporary.
- Laboratory-grown: Under this one, the skin cells will be taken the patient or the donor, so as to grow new skin (in a laboratory setting).
- Prosthetic: The procedure will be done using prosthetic implants, that is, synthetic materials such as metal, plastic, or ceramic.
Further,
the medical procedure is classified by the thickness and the nature of
the skin that has been removed. And depending upon the size as well as
the location of the wound, the types of the graft to be received is
determined .
And the three major types of skin grafting procedure are as follows
1. Split-thickness
Also
termed as STSG or split-thickness skin graft, this procedure involves
the epidermis and part of the dermis; and removing the top layer of the
skin. The grafts extracted are further categorised as thin,
intermediate, or thick based on the thickness of the dermis taken for
grafting.
The skin can be stretched out nine times more than its
original size, and the stretching is done by making it into a mesh. It
is made processed into a mesh using a skin mesher, which will allow the
skin to cover large areas.
STSG tend to contract over time,
making the area of surgery look a little odd. Hence, it is usually used
for larger areas and is avoided when it comes to joints and other places
because the contraction of the skin can cause hindrance in ease of
movement.
2. Full-thickness
This procedure involves
removing the entire thickness of the dermis and epidermis from the donor
site. In comparison to STSG, full-thickness is less painful to have a
more natural and aesthetically pleasing end-result. It is used for
smaller areas such as hands or face, in line with cosmetic concerns.
These blend well with the skin and has a better outcome than other
methods. This is done when there is plenty of tissue loss such as an
open fracture.
3. Composite
Under this one, skin and
underlying cartilage from the donor site will be used. For example, a
graft from the ear will be used to treat the nose. The cartilage under
the skin is to add form during the process.
