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Skin Grafts: Before Your Surgery

What is skin graft surgery?

Skin grafts are very thin sheets of healthy skin taken from one part of the body and put on another part. They are used to treat skin damaged by burns, infection, or injury. When possible, the doctor takes the healthy skin from a place that is hard to see or that's often covered by clothes.

In many cases, skin grafts only use the top layer of skin. This is called a split-thickness graft. When more layers are needed, it's called a full-thickness graft. The kind you need depends on how much damage you have and where it is.

In a split-thickness graft, the doctor removes a strip of healthy skin with a special tool. This skin usually comes from the inner thigh or rear end (buttocks). Then the doctor puts the strip on the damaged area and attaches it with stitches or staples. If the area is large, the doctor uses several small strips. You will grow a new layer of skin in the place where the strips of skin were removed.

In a full-thickness graft, only small pieces of skin are used. This is because the skin does not grow back and the edges have to be stitched together. Skin for this type of graft usually comes from behind the ears or from the neck, upper arm, lower belly, or groin area.

If the graft is small, the doctor will probably give you a shot of medicine to numb the area before surgery. For a larger one, you will probably get medicine to make you sleep during surgery.

After surgery, you may have a bandage stitched over the graft. The doctor will remove this in 4 to 10 days. The stitches or staples will be removed in 7 to 10 days.

For small grafts, you will probably go home 1 to 2 hours after surgery. For large grafts or ones in difficult areas, you may need to spend 5 to 10 days in the hospital.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The time it takes to do the skin graft depends on how much damaged skin needs to be covered.
  • You will have bandages taped, wrapped, or stitched over graft areas.
  • For large skin graft surgery, you will probably go to your hospital room after 1 to 2 hours in the recovery room. For a small graft, you may be able to go home 1 to 2 hours after surgery.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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