Cosmetic surgeries are aimed at enhancing beauty
and removing unwanted skin appearances. Skin grafting is one such procedure
that has helped numerous patients worldwide live healthy lives after severe
trauma due to an accident or serious injuries and burns.
grafts-when are they required?
Skin grafting is a surgical procedure wherein
the skin from one part of the body is removed or peeled, and transplanted to
another part of the body. The transplanted part is known as the 'skin graft'.
Also known as skin auto grafting, skin transplant, full thickness skin graft
and split thickness skin graft, this surgery is carried out when a patient has
suffered from burns, a skin infection or ulcer, or has undergone a surgery for
Accident survivors with large wounds that cannot
be closed even by a surgeon may also require to undergo this procedure. Also,
diabetic patients having non-healing ulcers can benefit from this surgery.
The surgical procedure is carried out under
general anesthesia as it can be quite painful. To extract the skin graft from a
healthy area, the surgeon uses an instrument called 'dermatome'. This
instrument removes the epidermis and a part of the dermis from the healthy
skin, leaving behind hair follicles and a few epidermal cells on the skin,
which proliferate and heal within a few days. This area can be quite painful
and is extremely susceptible to infections.
The skin graft is then placed over the required
area and held in place by staples, stitches or heavy dressings. It is then
nourished by allowing it to imbibe plasma and encourage blood vessel formation,
promoting speedy healing.
of healthy tissue from the patient itself is known as an allograft.
Xenograft refers to a
skin graft obtained from an animal (mostly pig).
graft involves the removal of the skin graft from the patient itself. This
grafting requires a good amount of physical strength from the patient and
cannot be performed on patients who have recently undergone traumatic accidents
or burns. Use of auto grafts demonstrates minimal tissue rejection.
Skin graft obtained from
a monozygotic twin is known as an Isograft.
grafts make use of metals, ceramic, or other synthetic materials to replace the
cases of shallow wounds or minor burns, split thickness grafts are used. They
involve the extraction of epidermis and a part of the dermal tissue only.
thickness grafts are used in case of major burns and extensive injuries. They
require extraction of the epidermis, dermis and the hypodermis from the donor.
that include bone, muscle and/or tendons require composite grafts. Nose
reconstruction surgery is a good example of a composite graft.
Since the donor area is exposed and has lost the
protective layer of the skin (epidermis), it becomes highly susceptible to
infections. Bleeding and nerve damage have also been observed among 13%
patients that have undergone this surgical procedure. In cases when the skin
graft is not extracted from the patient itself (xenograft), rejection may
occur, which may need to be treated by immunosuppressant drugs.
Other complications include loss of skin
sensation or increased sensitivity, chronic pain, reaction to medications and
breathing problems. Irregular tissue, scarring and discoloration of skin make
it look less aesthetically appealing.
There is not enough healthy donor skin available
for patients who have suffered 80-90% burns. Research on artificial skin
development is being conducted since the late 1970's and finally, the
introduction of 'Integra' a new artificial skin design has proved to be a boon
to patients suffering 2nd
Integra doesn't replicate the function of healthy
skin; in fact, it tricks the skin to grow back in a manner similar to normal
wound recovery process by stimulating fibroblasts to generate collagen fibers.
It acts as a stimulator and can be peeled of the skin once the dermis is fully