Healing and Complications of Skin Grafts
Skin cannot survive without oxygen. The best way to infuse skin cells with oxygen and other nutrients is through the blood. Healthy, living skin is full of tiny blood vessels that channel the body's blood supply to grow new skin cells and sustain older ones.
For a skin graft to heal, it must grow and activate new blood vessels. In a successful graft, this regeneration process begins as quickly as 36 hours after surgery [source: Medline Plus].
Because oxygen is so important to the healing process, some doctors prescribe hyperbaric oxygen therapy. Perhaps you've heard of a hyperbaric chamber. It looks like a long, glass-walled tube surrounding a raised bed. Inside a hyperbaric chamber, the patient is exposed to a 100 percent oxygen environment at twice the normal atmospheric pressure. These intense blasts of pure oxygen can speed the healing process of skin grafts.
Another healing technique is something called vacuum-assisted closure (VAC). In this post-operative procedure, the grafted skin is dressed with a porous bandage and attached to a tube that connects to a vacuum source. The vacuum helps draw out interstitial fluids and encourage blood flow to the graft. All potentially infectious fluids are sucked out of the wound for easy disposal. Some surgeons are so impressed with the technique that they leave the VAC tube attached for up to seven days after surgery without even changing the dressing [source: Carson].
The healing process for skin grafts can be slow, depending on the severity of the wound and the size and depth of the donor sites. Patients who receive full-thickness grafts may need to stay in the hospital for as long as two weeks to keep the graft stabilized and infection-free. Split-thickness grafts may only require a few nights at the hospital.
In all cases, patients will have to be very gentle with their graft areas when they get home. They should avoid stretching the skin and abstain from vigorous physical activity for at least a month. Remember that the donor site may take a couple a weeks to heal, too.
All skin grafts leave scars, both in the donor site area and the graft itself. Full-thickness grafts leave a less noticeable scar, because they contain functional blood vessels. Split-thickness grafts, which lack sweat glands, hair follicles and blood vessels, are discolored and need to be moisturized frequently to avoid scaling and chafing.
Unfortunately, some skin grafts can form infections in the area between the donor skin and the wound. Fluid can build up underneath the donor skin, preventing it from successfully attaching to the wound site. In these cases, the graft is said to "fail," and will need to be reattempted with a new batch of donor skin.
All in all, skin grafts can be painful, difficult procedures. The good news is that medical researchers have developed artificial skin products to minimize the use of donor skin and speed the healing process. Read more about lab-grown skin on the next page.