The procedure for harvesting and grafting skin varies somewhat according to the size, the extent of grafting needed to cover the wounded site, and the type of cosmetic reconstruction required. For example, extensive facial wounds that involve the nose, lips, or eyes may require skin grafting and a series of plastic surgery interventions to reconstruct normal function and appearance. However, most skin grafting follows a common general procedure.
The size of the wound (recipient site) is measured, and a template or pattern of the area to be covered is made. Then a donor site is selected. Although skin can be grafted from any site on the body, care is usually taken to select a site that matches the recipient site in color. Common donor sites are the underside of the wrist, the abdomen or upper thigh. The pattern or template is laid on the donor site and an outline is made. Local anesthesia is injected into the donor and recipient sites. If the area to be grafted is large, general anesthesia may be used. The skin is harvested using a scalpel or a special cutting tool called a dermatome. The donor site is covered with gauze. Any rough edges or fat adhering to the donor skin are removed. If the skin graft must cover an irregular surface, such as a finger, the donor skin may be passed through a mechanical device that produces multiple uniform slits in the skin graft to produce a mesh-like effect that conforms better to the irregular surface. The graft is then anchored into place with stitches and, possibly, staples. A snug dressing (pressure dressing) is applied to minimize lifting and movement of the grafted skin. |
Source: Medical Disability Advisor