Skin grafts are layers of skin which are taken from a suitable donor area of a patient and transplanted to a recipient area of damaged skin. Skin grafts can either be split thickness, a very thin layer or part of the skin, or full thickness layers which include all the layers of skin. Thinner grafts survive
transplantation more readily and are more successful. They are used for heavily contaminated surfaces, burn areas and surfaces with a poor blood supply. However, they are least like normal skin with loss of suppleness, hair does not tend to grow on them and their final appearance can be a disappointment. Full thickness grafts are more pleasing to the eye, look more like skin and can withstand a greater amount of trauma once they are successfully implanted. Meshed grafts allow for a greater degree of covering because the original graft is rolled under a perforating machine and the perforations produced allow for expansion thus increasing the surface area of the graft.
Skin grafting is used to replace skin cover. It is used in the treatment of extensive burn areas of skin,
varicose ulcers and after surgical excision of skin cancers including malignant melanomas. Infection and lack of a satisfactory blood supply prevent grafts from surviving.
Complications include infection,
seroma and/or
hematoma formation, and graft contracture. Although
wound infection is rare in skin grafting on the head and neck if good surgical technique is maintained, patients with
diabetes, those with immune-suppression, and those in whom the intra-operative time is prolonged may be predisposed to infection.