Donor site following skin graft

This page provides clinical guidance on the donor site following skin graft for health professionals.

The following information about donor site following skin graft is taken from 3D Regional HealthPathways, accessed April 2020:

Red flags
  • Sepsis
  • Excessive and uncontrolled bleeding

Background

About donor sites following skin graft

  • The donor site is where a thin shaving of skin has been taken from one part of the body to be used as a skin graft.
  • A full thickness skin graft may have been taken in some cases. However, these are usually directly closed with a suture line.

Assessment

  1. History:
    • Assess location and date of surgery.
    • Consider factors that may affect healing.
  2. Examination – Leave the material tape (Hypafix) in place and assess for:
    • fresh bleeding or old collection of congealed blood. It is not unusual for the donor site to bleed in the first few days after surgery.
    • symptoms or signs of infection. If present:
        ◊ If before the first planned check (at 10 to 14 days), seek advice from the original surgical team e.g., plastic surgery before deciding whether to remove the Hypafix.
        ◊ If removal of the Hypafix is necessary, remove by soaking it with oil and gently removing it, or by soaking it off in the shower.

Management

  1. If bleeding occurs:
    • Change the outer pad and leave the Mefix Hypafix in place.
    • If excessive and uncontrolled bleeding, apply pressure, and seek advice from the original surgical team e.g., plastic surgery.
  2. If symptoms or signs of infection:
    • See wound infections.
    • If any concerns, seek advice from the original surgical team e.g., plastic surgery.
  3. The Hypafix should start to separate from healed epithelium in 10 to 14 days:
    • Trim with scissors as it lifts away.
    • If Hypafix comes loose or lifts off and the donor site is unhealed, replace with fresh Hypafix.
    • If it has not separated after three weeks, remove the Hypafix by soaking it with oil and gently removing, or soak off in the shower.
  4. Advise the patient:
    • not to get the donor site dressing wet until the wound is largely healed.
    • to wash and dry the donor site gently once it is completely healed, apply moisturiser regularly, and protect it from the sun.
  5. If there are any concerns, seek advice from the original surgical team e.g., plastic surgery.

Learn more

Skin grafting DermNet NZ
Good food for wound healing Capital & Coast DHB, NZ
Protein rich meal ideas to help wound healing Capital & Coast DHB, NZ

References

  1. Donor site following skin graft 3D Regional HealthPathways, NZ, 2020