Caring for your Full Thickness Skin Graft
Date issued: December 2024
For review: December 2026
Ref: A-663/HW/Plastic Surgery/Caring for your Full Thickness Skin Graft
PDF: Caring for your Full Thickness Skin Graft.pdf [pdf] 197KB
Why have I had a Full Thickness Skin Graft (FTSG)?
A FTSG is skin from an un-injured area taken to replace damaged tissue and cover a wound. This may be due to trauma or plastic surgery reconstruction following the removal of a lesion or skin cancers.
What is a Full Thickness Skin Graft?
Skin is made up of two layers, the epidermis and the dermis. A FTSG contains both layers and is taken from an area of healthy skin and used to cover the wound or defect.
What are the benefits of a FTSG?
-
Help to heal the area significantly quicker.
-
Help reduce pain and discomfort when your dressing is changed.
-
Help to reduce the risk of infection.
-
Help reduce the chance of scarring.
-
Cover an area that has lost skin.
What to expect after surgery
It is important to follow your surgeon’s instructions on your discharge paperwork. You will likely be advised to:
-
Arrange a period of rest for 1 week
-
Keep the area clean and dry
-
Elevate the grafted area, this may include sleeping upright.
-
Take regular analgesia (pain killers) to stay comfortable.
-
Surgery to the face can result in bruising, this should resolve within 2 weeks.
The graft is usually secured with a surgical foam dressing known as a tie-over that can be stitched to secure. The first dressing change will occur 5-7 days after surgery with a nurse at the Plastics Dressing clinic (PDC).
The graft will hopefully have established a healthy blood supply, appear pink and be adhering well to the wound bed. The majority of FTSGs will not require a dressing at this stage, if it does the PDC nurse will advise you. FTSG are secured using absorbable sutures, as the graft heals, they will dissolve and wash away.
When dressings are no longer required you can wash and moisturise the graft. Use a non-perfumed moisturiser to prevent irritation (such as E45, Aveeno®, Cerave® etc.)
Donor site
The FTSG is harvested from a donor site, usually from behind the ear, upper arm or upper chest.
This area will be directly closed at the time of surgery and dressed for one week.
The PDC nurse will review the wound and remove any sutures in-situ, unless they are absorbable. There will be a small scar, usually in a straight line.
Once healed this area can be washed and moisturised.
Risks and complications
The FTSG is taken from one site and must grow blood vessel to survive in its new destination and anything which slows this process can cause complications.
-
Infection: can cause partial or full graft loss.
-
Friction/Shearing: your surgeon may advise you to rest for a period, especially if the graft is on your leg, to prevent it from moving under the dressings.
-
Bleeding: blood and fluid in excessive amounts may cause the graft to lift from the wound bed.
-
Smoking: this will limit the blood supply to the wound bed. We strongly advise that you do not smoke.
-
Altered sensation: The skin around the graft and donor site may be numb or hypersensitive at first, but usually fades over time.
Long-term care
The graft will take up to 18-24 months to fully mature and may appear indented to start with, but this may fill out overtime.
Most FTSG are pale to start to begin with but develop a more natural colour over time. The graft can darken if exposed to the sun. Therefore, it is important to keep it covered or use a high factor suncream (50%+spf)
To help the graft mature, moisturise twice a day with non-perfumed lotion such as Aveeno® or Cerave®.
Continue to do this for up to 3-6 months. Avoid sports for 6 weeks unless advised otherwise.
This information is generic and if you have any concerns please contact the plastics dressing team.
Contact information
Plastics Dressing Clinic
Derriford Hospital,
Level 4
Plymouth
PL6 8DH
Tel: 01752 432105
