Vitiligo Surgery

What is a skin graft?

A skin graft consists of skin taken from another part of the body and applied to the site where the skin is missing. This may follow surgical removal of skin cancer or an injury such as a burn or other trauma. A skin graft is a free piece of tissue without its own blood supply (as compared with a skin flap) and therefore its survival relies completely on nutrients from the wound bed on which it is placed.

 

Why do you need a skin graft?

A skin graft is required when the area of skin loss is too big to be closed using local skin and stitches alone. The skin graft covers the wound and attaches itself to the cells beneath and begins to grow in its new location. If a skin graft wasn’t performed, the area would be an open wound and take much longer to heal.

 

Will I have a scar?

It is impossible to cut the skin without scarring of some degree. The final cosmetic result of a skin graft depends on many factors including the type of skin graft, the location, the size and depth of the wound, and patient factors. Because skin grafts are effectively a patch without their own blood supply and sometimes of less thickness than the wound they are applied to, the final appearance may not be as close to normal as it would be if the wound was able to be closed in a straight line or with a skin flap. They have a tendency to look paler and flatter than the surrounding skin with time.
You will have two scars, the scar where the skin graft has been applied and the scar from where the skin graft was taken (donor site). The donor site for a full-thickness skin graft will usually be closed in a straight line with stitches. The donor site for a split-thickness graft however will consist of a superficial graze and will heal itself more slowly (initially under a special dressing). This grazed area can often be tender post-operatively and require some oral pain relief such as paracetamol.
Some people have an abnormal response to skin healing resulting in larger scars than usual (keloid or hypertrophic scarring).

 

What are the types of skin grafts?

Split skin grafts
This type of skin graft is taken by shaving the surface layers (epidermis and a variable thickness of dermis) of the skin with a large knife called a dermatome. The shaved piece of skin is then applied to the wound. This type of skin graft is often taken from the leg. A split skin graft is often used after the excision of a lesion on the lower leg.
Full-thickness skin grafts
This type of skin graft is taken by removing all the layers of the skin with a scalpel (a Wolfe graft). It is done in a similar way to skin excision. The piece of skin is cut into the correct shape, then applied to the wound. This type of skin graft is often taken from the arm, neck or behind the ear. It is often used after excisions on the hand or face.