An Introduction to Skin Grafting

What is Skin Grafting?

Skin grafting in the most basic sense refers to the transplant of skin from one part of the body to another. This technique was first implemented some 2500-3000 years ago by Hindu Tilemaker Caste for restructuring noses that were destructed as a judicial punishment back then. Though the basic skin grafting technique has evolved to a great extent and thus, it is one of the most common dermatologic surgeries today.

Why is Skin Grafting Done?

Skin grafting is basically done to create a protective barrier against open wounds, burns, infections, pressure ulcers (bedsores), or diabetic ulcers [that do not respond to normal treatment] etc. Also it promotes the healing of formerly mentioned skin issues.
Further, skin grafting has now become an integral part of post-mastectomy breast reconstruction and various other surgeries to eliminate cancerous cells.

skin grafting procedure
Skin Grafting Procedure

Where is the Skin Taken from to Perform Skin Grafting?

Generally the skin is harvested from the patient’s body itself which is termed as ‘Autograft’. It is considered best to do Autografting as the chances of body rejecting the skin are minimal. The fleshy parts of body like thighs and buttocks are targeted for skin harvesting. Other body parts considered for skin harvesting are forearms, upper arm, abdomen, etc.
Other alternative skin sources for grafting are:
- Skin sourced from a corpse (called an Allograft)
- Skin sourced from an animal (called a Xenograft)
- Synthetic tissues

Skin Grafting Techniques

Split-Thickness Graft: This is the most common technique of skin grafting, wherein, the top layer of skin (Epidermis) and a part of skin’s middle layer (Dermis) is removed. This technique is used more often as it allows the source area to heal up quickly. Though, the negative aspect of this technique is that the graft created from this is more fragile and can lead to abnormal pigmentation at the sourced area.

Full-Thickness Graft: Under this technique, all the three layers of skin – top (Epidermis), middle (Dermis) and bottom (Hypodermis) are removed completely. Cosmetically, this technique renders much better results than split-thickness and thus, it is generally advised for facial corrections. The only drawback in this technique is that it can be done at areas that feature considerable amount of blood vessels to support graft’s life.

Composite Graft: This technique skin grafting technique can call for the removal of skin, fat, muscle, and cartilage. Composite graft is specifically required in situations where three-dimensional reconstruction is required. For e.g. – Nose