Skin grafts

Skin grafts are very thin sheets of healthy skin taken from one part of the body and put on another part. They are used to treat skin damaged by burns, infection, or injury. When possible, the doctor takes the healthy skin from a place that is hard to see or that's often covered by clothes.

In many cases, skin grafts only use the top layer of skin. This is called a split-thickness graft. When more layers are needed, it's called a full-thickness graft. The kind you need depends on how much damage you have and where it is.

In a split-thickness graft, the doctor removes a strip of healthy skin with a special tool. This skin usually comes from the inner thigh or rear end (buttocks). Then the doctor puts the strip on the damaged area and attaches it with stitches or staples. If the area is large, the doctor uses several small strips. You will grow a new layer of skin in the place where the strips of skin were removed.

In a full-thickness graft, only small pieces of skin are used. This is because the skin does not grow back and the edges have to be stitched together. Skin for this type of graft usually comes from behind the ears or from the neck, upper arm, lower belly, or groin area.

If the graft is small, the doctor will probably give you a shot of medicine to numb the area before surgery. For a larger one, you will probably get medicine to make you sleep during surgery.

After surgery, you may have a bandage stitched over the graft. The doctor will remove this in 4 to 10 days. The stitches or staples will be removed in 7 to 10 days.

For small grafts, you will probably go home 1 to 2 hours after surgery. For large grafts or ones in difficult areas, you may need to spend 5 to 10 days in the hospital.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that it will help the damaged skin heal. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day, unless the grafted area is on your foot or leg. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow to the skin grafts.
• Ask your doctor when you can drive again.
• Your doctor will tell you when you can return to work. It depends on the size of the skin graft, what part of your body was grafted, the type of work you do, and how you feel.
• Your doctor will tell you when you can take a shower. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Skin graft and donor site care

• Leave the bandages on the skin graft and donor site until your doctor says you can take them off. You probably will receive instructions on how to change the bandages. Follow these instructions closely.
• Keep the area clean and dry, unless your doctor tells you differently.
• Do not rub the skin graft for 3 to 4 weeks.