Caring for your Split Skin Graft
Date issued: January 2024
Review date: January 2026
Ref: B-506/HW/Plastic Surgery/Caring for your Split Skin Graft
PDF: Caring for your split skin graft.pdf[pdf] 248KB
Why have I had a skin graft?
A skin graft is skin from an uninjured area taken to replace damaged tissue and cover a wound. This may be due to a burn, trauma or surgical reconstruction.
What is a skin graft?
A skin graft is when an area of healthy skin is taken from what we call a donor site and used to cover a wound or defect. A split skin graft (SSG) uses top layers only which allow the donor site to regrow skin.
What are the benefits of a skin graft?
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Help to heal the area significantly quicker.
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Help reduce pain and discomfort during dressing changes.
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Help to reduce the risk of infection.
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Help reduce the chance of scarring.
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Cover an area that has lost skin.
Split skin graft
The first dressing change usually occurs 5-7 days after surgery, either with your GP practice or in the Plastic surgery dressing clinic. The graft will hopefully have established a healthy blood supply, appear pink and be adhering well to the wound bed. An appropriate dressing will be reapplied.
The dressing can be changed every 3-4 days by your practice nurse. Most skin grafts are secured using absorbable sutures and glue, as the graft heals these will dissolve and wash away.
Most grafts heal within 2-3 weeks, though this can vary. As the graft matures, the meshed appearance will disappear, it will be dry to touch and look like new skin. When dressings are no longer required you should now wash and moisturise the graft. Use a non-perfumed moisturiser to prevent irritation (such as E45®, Aveeno®, Cerave® etc)
Donor site
The SSG is harvested from a donor site, usually on the thigh but other areas such as the scalp, buttocks or abdomen may be used. SSG can be taken from any part of your body.
You will have a dressing on your donor site. Initially there may be some oozing from the dressing and the site may be painful. This is very normal, and we encourage you to take regular analgesia as required. The outer dressings can be repadded.
We recommend that these dressings are left on for 2 weeks to allow a new top layer of skin to form. (1 week if SSG taken from the scalp) The dressings can be removed at home or by a practice nurse at your GP surgery; it should peel off easily and be relatively painless.
Once healed this area can be washed and moisturised. Initially, the donor area may appear red or purple, this will fade over the following 12-18 months, but a scar will remain.
Risks and complications
The Skin graft is taken from one site and must grow blood vessels to survive in its new environment. Any interruption to this process can cause complications. This includes:
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Infection: can cause partial or full graft loss.
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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.
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Bleeding: blood & fluid in excessive amounts may cause the graft to lift from the wound bed.
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Smoking: this will limit the blood supply to the wound bed. We strongly advise that you do not smoke.
Please also consider:
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Altered sensation: the skin around the graft and donor site may be numb or hypersensitive at first, but usually fades over time.
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Scarring: once healed, massaging can help to minimise the appearance of scars
Long term care
Skin grafts (SSG) take between 18 monthS to 2 years to mature. It may look red/purple in appearance; over time the colour will fade but may never completely match your surrounding skin.
With SSG’s, it is normal for it not to feel as smooth as the surrounding skin and there may be an indentation (dip) at the graft site. With time this dip may become less obvious but will not completely disappear.
The new skin graft will be very prone to sunburn and needs to be protected. Cover with clothing and use sunscreen (SPF >50). Sun exposure will affect final colour.
The advice given in this leaflet is generalised and every individual case is different. If you have any queries or concerns, please contact a member of the Plastics team.
