How is a skin graft performed

Skin graft: when the wound is too large

The skin is able to close its own wounds. If there is a skin defect that cannot be closed by suturing or conservative therapy, a skin graft is performed. For this purpose, parts of the skin are removed from a healthy part of the body and reinserted in the affected part of the body. With the help of a powerful microscope and very fine instruments, individual nerve fibers and entire nerve cords are put back together. This can prevent paralysis and sensory disorders. The functions of individual limbs and body regions can also be restored in this way. Another positive effect is the often associated reduction in pain.

Fast healing is essential

Reasons for a skin tissue transplant are:

  • Severe burns
  • Skin burns
  • Operations with great loss of skin
  • Chronic ulcers, e.g. B. due to diabetes mellitus or a peripheral arterial occlusive disease, PAD for short

A transplant is often considered in order to prevent the risk of infection and high fluid loss in the case of large wounds. A skin transplant is particularly suitable for skin defects that heal very slowly. Skin surgeons achieve the best results when the wound bed is well supplied with blood and is even. Thanks to modern technologies, it is now possible to successfully treat patients who have more than 70 percent of the body surface burned.

Transplant procedure: cover the wound

There are several different skin grafting procedures. Which of these comes into question depends on the nature, type and size of the wound:

  • Full skin transplant: This method is used for mechanically and motorically stressful wounds, e.g. B. on the foot or on the hand. Full skin is the term used for skin and its appendages - this includes sweat and sebum glands as well as hair follicles. Sometimes the underlying fatty tissue is also removed. The full skin should be as close as possible to the wound to be covered, e.g. B. in front of the ear, on the neck or on the groin. Since full skin retains its color and shrinks less, it is also used to cover cosmetically conspicuous areas, e.g. B. in the face.
  • Split skin grafting: This procedure is used for larger wounds or burns. The transplant is removed with a surgical knife, a dermatome, from a healthy part of the body, e.g. B. buttocks, thighs or abdomen. The removed graft is called split skin and is very thin. This split skin is stretched and fixed on the wound, where it grows in within a few days.
  • Mesh Transplant: This method is used especially for large burns where the possibility of removing skin is limited. Here removed split skin is rotated by a knife roller and provided with a diamond-shaped cutting pattern. Due to the now holey structure, the transplant can be enlarged up to six times. This also covers very large skin defects.
  • More techniques: If healthy skin is available in the immediate vicinity of the wound, the skin surgeon can partially cut out a skin flap and twist it into the wound area. There are also transplants for which the patient's own skin is grown in the laboratory in order to obtain more skin. Silicone foils or non-autologous donor skin can be used as temporary solutions. In the healing process, these are gradually replaced by the body's own skin in order to avoid rejection reactions.

Support skin healing

The freshly transplanted skin is very sensitive and needs particularly good care. In the first few days after the operation, it is important not to move the affected area. A splint or plaster cast is used to put pressure on the graft so that it bonds well to the tissue.

To aid wound healing, consider the following tips:

  • Regular care with a wound and healing ointment, e.g. B. with the active ingredient dexpanthenol, promotes healing.
  • After the skin has grown safely, begin exercise. This will prevent any movement restrictions caused by scarring. Physiotherapy or occupational therapy can help.
  • In order to protect the light-sensitive tissue from the sun's rays, experts recommend an ointment containing panthenol with UV protection.
  • Massage the already grown tissue daily with the ointment to keep it soft, promote lymph flow and reduce the risk of bulging scars.