Skin Transplant: a Reconstructive Surgery
Skin Transplant: Risk factors, Diagnosis, and Treatment
Skin transplant or skin graft is a type of graft surgery that involves the transplant of skin and the tissues that are transplanted are called skin graft. The skin graft is usually done in cases of severe injury when body tissues are injured. Skin transplant is often used in the following conditions:
- In burn injury.
- After severe trauma of the injury.
- Excessive skin loss due to infection like purpura-fulminant or necrotizing fasciitis.
- In certain surgeries, skin graft is required, such as in cases of removal of skin cancer surgery.
Skin graft not only have cosmetic importance by enhancing the look of the patient but also helps to fasten the process of healing, thereby, reducing the course of treatment.
Types of skin grafts:
There are three main types of skin graft:
- Split thickness graft: It is the most common type of skin graft. In this type of graft, the epidermis or the topmost layer of the skin is removed along with a little part of the dermis.
- Full-thickness graft: This type of graft is usually recommended for face surgery. The epidermis, dermis and the hypodermic are transplanted.
- Composite skin graft: This type of graft is used for three-dimensional reconstruction such as the nose. This type of transplant involves grafting of skin, muscles fats and cartilage.
Risk and complications of skin transplant:
The potential risk of skin graft are:
- Scarring of the skin
- Irregularity of skin texture
- Death of skin graft
- Loss of sensation
- Hypersensitivity of skin
The wound that needs a graft is first cleaned and is then measured to ensure the number of cells needed for transplant.
Anesthesia is administered, the anesthesia can be either local or general depending on the age, location of injury and nature of the injury.
What to expect during the procedure?
The harvested donor skin is removed by a scalpel or “dermatome” which is a special device used to harvest the skin. The donor skin sometimes harvested using the of “messing”; which is involves making several small controlled incision placed in the graft allowing fluid to leak from the underlying tissue of the donor skin cells to spread over a large area. After extraction of the skin cells, the site is closed in case of full-thickness graft or composite graft sutures are also required to close the wound.
The graft is then transplanted to the recipient. The graft is placed at the correct site and is then sutured to the neighboring tissues. A pressure bandage is then applied at the site of skin transplant along with a vacuum device called wound VAC which controls drainage this increases the chances of graft survival.
Initially, the graft gets its nutrition from the neighboring cells but once when healing process sets in the graft forms new blood vessels, followed by the growth of new cells. Thus, covering the area with new skin cells.
Both living donors and recipient must take care that the wound is kept moist and well protected.