Skin grafting is a surgical method of replacing skin to cover wounds on the body’s surface. Skin grafts are especially useful in healing severe burns. Loss of skin due to serious accidents, disease, or surgery may also require skin grafting.
Most skin grafts involve taking healthy skin from one part of a patient’s body to cover a wound on another part of the body. This type of skin graft is called an isograft or autograft. The grafted skin may be either full thickness or partial thickness. A full thickness graft includes all the epidermis (top layer of skin) and the dermis (layer of blood vessels, nerve endings, and connective tissue). A partial thickness graft uses all of the epidermis but only a little of the dermis.
The part of the body from which the skin graft has been taken is called the donor site. If a partial thickness skin graft has been removed, the donor site heals in several days, much like a “skinned” knee or ordinary scrape. When a full thickness graft is removed, the donor site must be closed surgically. The final result of a skin graft does not feel or appear exactly like normal, uninjured skin. After several years, however, the differences between grafted skin and normal skin are usually slight.
Some patients do not have enough undamaged skin to provide isografts for the entire wound. In such cases, surgeons may cover some of the wound with temporary skin grafts. These grafts help prevent infections and fluid loss, but the body eventually rejects the covering. Many temporary grafts use skin from another person. Such grafts are called homografts or allografts. Other temporary grafts, known as heterografts or xenografts, use specially prepared skin from pigs or other animals. Surgeons replace temporary grafts with isografts after the patient’s body has produced new skin at earlier donor sites. Researchers have also developed “artificial skins” that can serve as temporary grafts.
In the mid-1980’s, surgeons began using large sheets of “test tube” skin grown in a laboratory to serve as permanent grafts for victims of extensive burns. The skin is grown from tiny patches of healthy skin taken from the patient’s body.
