Skin Grafting

Skin grafting has become a very important mean in reconstructing a defect on the skin not taking into account what caused that specific defect. It is used for the reconstruction of the skin due to the surgical removal of some cutaneous malignancies but at the same time it can be used as a cover up for the not healing cutaneous ulcers, terrible skin burns and to restore hair in alopecia areas.

Due to the continuous existence of skin cancer, surgical procedures will continue to develop defects but as a saving technique it most cases nowadays, skin grafting can be used at its full effect.

Although it is fairly recommended that you will understand all the procedure techniques before undertaking such a procedure and try to keep focused on the end goal as having a disease free body without taking into account the physical defect because there are cases where skin grafting will just not be enough.

Skin grafting will not be used as a primary choice in reconstruction but the reconstructive surgeon will have to rule out all the other types of reconstruction like primary closure and second intention healing. Such a procedure will be catalogued into two major categories: split thickness skin grafts STSGs and full thickness skin grafts FTSGs. The first category also can be divided into thick grafts of 0,018 up to 0.030mm, medium grafts of 0,012 – 0,018 mm and thin grafts of 0.008 up to 0.012 mm.

Although primarily it was used only for reconstructions, in time skin grafting has become a normal procedure in other considerations and applications.

When cosmesis will not be a primary mean, STSGs will be used but also it can be used in the temporary coverage in allowing the observation of some possible tumor reoccurrence, the coverage of chronic not healing cutaneous ulcers, coverage of burns so that it will fasten the healing process and reduce the fluid loss and the surgical correction of the depigmentation disorders that will use the suction blister grafts in order to line cavities for example the orbit.

In comparison, FTSGs will be used in achieving successful outcomes when the donor region will be carefully selected and also the recipient and the donor will be thoroughly prepared. There has been an ongoing debate on what type of skin graft procedure is more useful and why but it is very subjective topic due to the nature of the injury that cannot be categorized in some columns and it will be up to the reconstructive surgeon to decide which type of reconstructive procedure the patient will need. Both procedures have their risks but at the same time they will not be life threatening, in case of any mismatch, a surgical procedure being undertaken immediately.

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