This page provides clinical guidance on skin grafts for health professionals.
The following information about skin grafts is taken from 3D Regional HealthPathways, accessed June 2020:
About skin grafts
Skin grafts can be:
- split skin i.e., thin shavings of skin, which are taken from one part of the body (donor site) and applied where trauma has caused skin loss (or a lesion has been removed) to facilitate healing.
- full thickness skin, which may be used for areas on the face or hands.
• Assess location, type of graft, and when the graft was applied.
• Consider factors that may affect healing.
• Primary dressings are usually left in situ for 5 days and first graft checks are usually done by the surgeon. Review earlier or at any stage if increasing pain, exudate, malodour, or bleeding.
• If review is necessary < 5 days after surgery, seek advice from the original surgical team e.g., plastic surgery, before deciding whether to remove any dressings.
• Remove dressings carefully, ensuring the graft is stabilised with forceps.
• Assess the wound and surrounding skin, looking for a healthy graft appearance. Graft failure can be due to infection, bleeding or haematoma, inadequate wound bed preparation, or other factors:
◊ Check temperature and pulse.
◊ Check for any bleeding or haematoma under the graft.
◊ Use the T.I.M.E.-S. model to assess the wound and surrounding skin.
- If review is necessary < 5 days after the graft, seek advice from the original surgical team e.g., plastic surgery.
- If symptoms or signs of infection:
• If local wound infection, take a wound swab and start oral antibiotics. Do not use topical antibiotics.
• If any concerns, seek advice from the original surgical team e.g., plastic surgery.
• See also Wound Infections.
- Manage any other factors that may affect healing.
- Cleanse the wound.
- Apply dressings. See Wound Management Products.
- Advise the patient to elevate affected limbs.
- Reassess the wound at appropriate intervals. If the wound fails to make expected progress, seek advice from the original surgical team e.g., plastic surgery.
- Skin grafts 3D Regional HealthPathways, NZ, 2020