It is commonly used to repair large but not too deep skin ulcers, diabetic or traumatic wounds, and burns. Secondary contraction is greatest in split thickness grafts. Superficial slices of skin the thickness of tissue paper are cut with a hand or mechanical razor. Skin graft is one of the most indispensable techniques in plastic surgery and dermatology. Splitthickness skin grafts have the epidermis and part of the dermis. Contains 100% of the epidermis and a portion of the dermis. Split thickness skin grafts clinical practice standard. 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. Following irb approval, patients were screened for approval. Split, or partialthickness, skin grafts are by far the most commonly used grafts in plastic surgery.
A thirddegree burn wound before split thickness skin graft. It is used with a dual mesh in reconstruction of full thickness defects of anterior abdominal wall and covered by skin grafts. 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. These layers are taken from the donor site, which is the area where the healthy skin is located. Discharge instructions for your split thickness skin graft site. 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. Primary contraction, an elastic recoil of the skin caused by retractile forces, occurs as soon as the graft is harvested. When a graft includes only a portion of the dermis, it is called a split. 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. 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. Fullthickness the harvested skin includes the epidermis the surface layer of the skin and all of the dermis. 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. The surgeon first marks the outline of the wound on the skin of the donor site, enlarging it by 35% to allow.
The two most common are split skin grafts and full thickness skin grafts. Under no circumstances are you to attempt to remove the bolster on your own. If you have any of the following symptoms, on the ward or at home, please. You will need to care for both the graft and donor sites as instructed so they heal properly. Split thickness skin graft is often taken from the leg. The advantages include the availability of a large donor site.
Several types of dressings can be used to heal donor sites for a split thickness skin graft. Ftsgs have limited donor sites and have less longterm contracture and scar formation. 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. The xeroform is the yellowcolor bandage that was applied to the thigh at the time of the surgery.
Discharge instructions for your skin graft site saint. Splitthickness skin grafting discharge care what you. About your split thickness skin graft this information describes surgery using a split thickness skin graft. Skin grafts can be categorized as a split thickness graft or a fullthickness graft. Skin cancer and split skin grafts st vincents hospital. A split thickness skin graft involves the epidermis and a little of the underlying dermis. 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. These patients presented to the plastic surgery service both inpatient and outpatient. A skin graft is healthy skin that is used to replace damaged or missing skin. A split skin graft is often used after excision of a lesion on the lower leg. The donor site of splitthickness skin grafts is covered with.
S diabetic patients without comorbidities have shown no significant difference in healing times compared to nondiabetic patients for stsg. Information leaflet for patients with a split skin graft ssg to the leg why a skin graft. A xenograft heterograft is a graft taken from an individual of one species that is grafted onto an individual of a different species. Patients undergoing a split skin graft as part of reconstructive surgery. Split thickness skin grafts can be taken from any area of the body, including the scalp fig. A fullthickness skin graft is composed of the epidermis and all of the dermis as well as variable amounts of subcutaneous tissue. 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. The possg is a pedicled graft based on either the right or left gastroepiploic arteries. Split thickness skin graft generally this wound is from the thigh region 1. Classification of splitthickness skin grafts skin grafts are classified according to origin and thickness. Split thickness skin grafts and complicated diabetic wounds. The technique of harvesting the split thickness skin grafts in this area requires the use of pitkins syringe and brown air dermatome. B 5 days post tangential excision of the eschar and skin grafting. This type of skin graft is taken by shaving the layers of the skin.
The area where the skin is taken from is called a donor site. A splitthickness skin graft stsg contains epi dermis and a variable amount of dermis. 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. A fullthickness skin graft is composed of the epidermis and all of the dermis as well as.
If the thigh wound and the xeroform are still moist, dry the wound and the. Depending on how much of the dermis is included, an stsg may be thin, intermediate medium, or thick. The halo split skin graft in the management of nonmelanoma skin cancer of the leg. Splitthickness skin grafts may be used for primary clo sure of a wound, as adjunctive treatment for wounds that have closed partially in response to other. This term is preferred over transplant in the case of skin grafts. 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. An autograft is a graft transferred from a donor to recipient site in the same individual. 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. Split skin grafts this is the top layer of skin epidermis.
Skin grafts, splitthickness and fullthickness woundsource. It is less painful than the alternate split thickness skin graft and tends to have a more natural and aesthetically pleasing end result. 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. You can start putting moisturizer on your skin graft or donor site after it is fully healed. Following preparation of the wound, the surgeon then harvests the tissue for grafting. Skin grafts and skin graft donor sites must be moisturized to lessen dryness, cracking, and itching. The areas most commonly used as donor sites for skins grafts are leg, inner thigh, upper arm, forearm and.
A splitthickness graft involves removing the top layer of the skin the epidermis as well as a portion of the deeper layer. The stsg is used to cover an area of skin that has been damaged or cannot heal because of an injury or abnormality. If the area is small and the skin nearby is loose, the wound can. Primary care physicians often see wounds in which skin loss is a major factor. Fullthickness skin grafts are done when a lot of tissue is lost. Split thickness skin graft an overview sciencedirect. Split thickness skin grafts and complicated diabetic wounds apma. Pdf the halo split skin graft in the management of non. Split thickness skin grafts s for both chronic and acute wounds, stsg offer a rapid and effective way to provide closure and healing. The shaved piece of skin is then applied to the wound. Burns which may heal without skin grafting would be dressed with a sterile dressing, a biosynthetic skin substitute, cultured skin, or skin allograft. This takes the two top layers of skin from the donor site the epidermis and the layer under the epidermis the dermis. 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. Splitthickness skin grafts remain the gold standard for.
Pdf skin graft is one of the most indispensable techniques in plastic surgery and dermatology. It is common to have some drainage clear yellow or red in color from a split thickness skin graft site. A split thickness skin graft stsg is a very thin shaving of normal skin taken from an undamaged area of the body. Healed grafts and donor sites are pink and dry, and do not have any drainage. The epidermis and part of the dermis are removed from the donor site and transplanted on the damaged area. Types of grafts 1 split or partial thickness graft thiersch grafts this is the most common type of graft. 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. However, not as much skin can be harvested and grafts are more likely to be rejected than with split thickness grafts. Split thickness or partial thickness skin graft stsgthis type of skin graft involves using the superficial layer i. Split thickness grafts are further classified as thin or thick. Pdf scalp as a donor site for split thickness skin grafts. 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. Type of graft advantages disadvantages thin split thickness best survival heals rapidly least resembles original skin.
The graft may be held in place by staples, stitches or surgical glue. 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. Skin grafts are generally classified as splitthickness or fullthickness grafts. Technical guide technical guide what you need to know. 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. Most people who are having a skin graft have a split thickness skin graft. His most concerning wound is his left posterior leg and achilles insertion region. Strategies to promote healing of split thickness skin grafts. Patients who were older than 17 years of age undergoing a split thickness skin graft were approached to participate in the study.
An allograft previ ously homograft is taken from another individual of the same species. Splitthickness grafts can survive in less ideal recipient sites with less vascularity, but the thinner the graft. Stsg uses the epidermis and some parts of the dermis skin layers taken from one area of the body and transplanted to another area. Healthy skin is taken from a place on your body called the donor site. Fullthickness skin grafts contain both the full epidermis and dermis. More modern uses of skin grafting were described in the midtolate 19th century, including reverdins use of the pinch graft in 1869. Moisturizing your skin graft and skin graft donor site. Treatment of skin graft donor sites using 3m tegaderm. Skin graft indications, procedure, aftercare and skin.