Skin grafting

Skin grafting is a surgical procedure in which skin or skin substitute is placed over a burn or wound to replace damaged skin or provide a temporary woundcovering.

Wounds such as third-degree burns must be covered as quickly as possible to prevent infection and loss of fluid. Without a skin graft, wounds can contract, causing serious scars. Wounds that don't heal well, such as diabetic ulcers, or bedsores, can be treated with skin grafts to prevent infection. Skin grafting isn't necessary for first-or second-degree burns, which heal with little or no scarring.

Skin protects the body from fluid loss, helps to regulate temperature, and helps keep out germs. More than 50,000 people are hospitalized with burns eachyear in the United States, and 5,500 die. Approximately 4 million people suffer from non-healing wounds.

Skin for grafting can be obtained from another part of the patient's body ifthere is enough undamaged skin available and if the person is healthy enoughto have extra surgery. Otherwise, skin can be obtained from another person (donor skin from cadavers is frozen, stored, and available for use), or from ananimal (usually a pig). However, skin from these other sources are only usedtemporarily, since they are rejected by the patient's immune system within 7to 10 days and must be replaced with a graft from the patient's own skin.

Several artificial skin products are available for burns or non-healing wounds. These products aren't rejected by the patient's body, and actually encourage the growth of new tissue. Artificial skin usually consists of a type of lattice which acts as a template for new skin to grow. This artificial latticeeventually breaks down as the new skin structure grows. A synthetic outer layer acts as a temporary barrier during this process, and is eventually replaced with a graft of the patient's own skin. The cost for the synthetic productsin about $1,000 for a 40-inch square piece of artificial skin, in addition to the costs of the surgery. This procedure is covered by insurance.

Once a skin graft has been put in place (and even after it heals), it must bemaintained carefully. Patients need to stay in bed for a few days and then wear special stockings or bandages to help support the new skin and keep it from contracting too much.

Since grafted skin doesn't contain sweat or oil glands, it should be lubricated daily for two to three months to prevent drying and cracking.

The risks of skin grafting include typical risks for any surgical procedure,including reactions to the drugs, breathing problems, bleeding, and infection. With a donor skin graft, there are also risks of getting an infectious diseases.

A skin graft should significantly improve the quality of the wound and may prevent serious complications. Sometimes grafts aren't successful, however, either because of poor blood flow, swelling, or infection.

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