Skin is the largest organ of the human body which consists of two main layers; the outer layer (epidermis) and the middle layer (dermis). Epidermis is composed of outer layer of keratinocytes that coats for protection and few layer those rapidly dividing cells just below the keratinocytes. The dermis contains the blood vessels, nerves, sweat glands, hair follicles and oil glands and mainly composed of connective tissue which made up of collagen. A skin graft is defined as a patch of skin that is removed from one part of the body and transplanted to another area through surgery. In another word, it is a surgical procedure which the skin substitute is placed over a burn or non-healing wound. It aims to replace the area of skin permanently that had been damaged and provides a temporary wound covering. This covering is essential because the skin will protect the body from fluid loss, helps in regulating the body’s temperature and aids to prevent disease-causing bacteria or viruses from entering accessing the body.

There are two basic types of skin grafts which are split-level thickness and full-thickness grafts. A split-level thickness graft involves the removal of the top layers of skin; the epidermis and dermis. These layers are taken from healthy skin that is called as the donor site. This type of skin grafts is used to cover large areas and primarily it is an area that is hidden by clothes such as the buttock or inner thigh. The grafts are easily to become fragile and have shiny and smooth appearance. Since split-level grafts don’t grow with the rest of the skin, therefore as the children grow older, they may need additional grafts. For the people that lost deeper tissue, he may need a full-thickness skin graft which needs the whole thickness of skin from the donor site and it is not just the top two layers. This type of skin graft actually is a more complicated procedure. Donor sites that are commonly used for full-thickness skin grafts are such as back, abdominal wall and chest wall. Full-thickness grafts fused together with the old skin and grow with the person. This surgery is usually done under general anesthesia which means patients will be asleep and painless. The graft is carefully spread on the bare area where it is being transplanted. It is handled in place by gentle pressure from a well-padded dressing that covers it, by staples or a few small stitches. The donor-site area is covered with a sterile dressing for 3 to 5 days.

The skin graft is performed due to many reasons. For examples, it’s most extensive use in the treatment of burns. For the first or second-degree burns, skin grafting is generally not needed because the burn usually heals with little and no scarring. Meanwhile, people who suffer from third-degree burns require skin grafting because the skin is destroyed to its full depth and in addiction to damage done to underlying tissues. Other than that, the other reasons to do graft skin are surgeries that need this procedure to heal and a very large wound that the surgeon is unable to close properly. A skin graft can speed up the recovery process for the large wound. There is also ulcer that does not heal such as venous ulcers, pressure ulcers or diabetic ulcer which acquire skin grafting. Next, it is also because of the areas that have been infected which caused a large amount of skin loss. Besides that, cosmetic reasons or reconstructive surgeries which lead to skin damage or loss of the skin also need to perform skin graft.

References:

graft, S. (2017). Skin graft: MedlinePlus Medical Encyclopedia. Medlineplus.gov. Retrieved 8 May 2017, from https://medlineplus.gov/ency/article/002982.htm

Skin Grafting – procedure, recovery, blood, pain, complications, adults, infection, medication. (2017). Surgeryencyclopedia.com. Retrieved 8 May 2017, from http://www.surgeryencyclopedia.com/Pa-St/Skin-Grafting.html

Skin Graft. (2017). Healthline. Retrieved 8 May 2017, from http://www.healthline.com/health/skin-graft#procedure5