UWHealth Skin Graft and Donor Site Care Instructions
- August 31, 2024
- UWHealth
Table of Contents
Skin Graft and Donor Site Care
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Product Information
Specifications:
-
Product Name: Skin Graft and Donor Site Care
-
Usage: Care for skin grafts and donor sites post-surgery
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Healing Time: 2 to 4 weeks or longer, varies per
individual -
Types of Skin Grafts: Full Thickness Skin Grafts (FTSG)
Product Usage Instructions
Skin Graft Site Care:
Skin graft care depends on the placement of the graft. Follow
these steps:
-
Stay in the hospital for a few days post-surgery for
monitoring. -
Expect stitches or surgical staples around the edges of the
skin graft. -
After surgery, some oozing of blood or yellow colored drainage
is common. -
A bolster bandage will be placed over the skin graft to promote
healing. -
Do not soak the bolster in water; keep it slightly wet.
-
Watch the skin graft closely and report any changes to your
surgeon.
Donor Site Care:
Care for the donor site with these steps:
-
A bandage will cover the donor site; follow the instructions
based on the size of the site. -
Your surgeon will advise when you can get the donor site
wet. -
If the bandage dries onto the site, peel it off slowly as new
skin heals underneath. -
Apply alcohol-free moisturizer to the skin as it heals
post-bandage removal.
Oral Care for a Skin Graft in Your Mouth:
If the skin graft is in your mouth, follow these oral care
steps:
-
Use a prescribed mouth wash to keep the mouth and bolster
clean. -
Rinse your mouth with plain water after meals to prevent food
contact with the graft.
Pain Control:
Manage pain with these tips:
- Expect soreness for 1-2 weeks post-surgery.
- Cover the donor site while it heals to reduce pain.
FAQ
Q: How long does it take for a skin graft to heal?
A: It typically takes 2 to 4 weeks or longer for a skin graft to
heal, varying per individual.
Q: What type of bandage is used for a skin graft?
A: A bolster bandage, a special yellow gauze, is often used to
cover a skin graft.
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Skin Graft and Donor Site Care
A skin graft is a patch of healthy skin that is removed from one part of the
body. This is called the donor site. It is then used to replace damaged or
missing skin. You will need to care for both the graft and donor sites as
instructed. This is so they heal properly. Follow instructions carefully. It
will take 2 to 4 weeks or longer for the graft to heal. This varies from
person to person. It may depend on the size of the graft.
Types of Skin Grafts
Split Thickness Skin Graft (STSG) A STSG involves removing the top layer of
the skin (epidermis) as well as a portion of the deeper layer of the skin (the
dermis). Common donor sites for a STSG are the upper front or outer thigh,
back of the upper arm, abdomen or back. If you have a STSG, it may be
“meshed.” This is to allow for it to cover a larger area without taking larger
donor skin. The meshing may cause the skin to take a “fishnet” like
appearance. The graft will start to develop new blood vessels and this will
give it a red or pink appearance which is normal. Then, it will connect to the
skin around it. This is usually within a week.
Full Thickness Skin Grafts (FTSG) A FTSG involves removing all the epidermis
and dermis from the donor site. FTSG are usually used to cover a smaller
wound. FTSG are more often used on the face. FTSG donor sites are often chosen
where the skin looks very similar in color and texture. Common donor sites are
the abdomen, area above the collarbone, neck or in front of or behind the ear.
You will have a cut where the donor skin was removed. Stiches are used to
close the wound.
What to Expect After Surgery
Skin Graft Site Care Skin graft care depends on where the graft was placed.
You may need to stay in the hospital for a few days. This is to make sure the
skin graft and donor site are starting to heal.
You will have stiches or surgical staples around the edges of your STSG. Some
oozing of blood or yellow colored drainage is common right after surgery.
The surgeon often will cover a STSG with a bandage called a “bolster.” A
bolster is a special type of yellow gauze. This is shaped to fit the size of
your graft. Then, it is sewn in place over the skin graft. The bolster applies
a light pressure to the graft. It keeps it in place to promote healing.
Do not try to remove the bolster bandage or the stiches around the edges.
Those will be removed by your surgeon about a week after surgery or at your
first post-op visit. You will be asked to apply a white petroleum ointment
(Vaseline®). Apply this around the edges of the bolster bandage twice daily to
keep the edges moist.
It is ok to get the bolster bandage slightly wet. Do not soak the bolster in
the shower or bath. Your surgeon will tell you when it is okay to allow the
skin graft to get more wet.
You will need to watch the skin graft closely. Report any changes to your
surgeon.
Donor Site Care You will have a bandage over your donor site. If you have a
smaller donor site, you may have a clear bandage covering it. This is called
Tegaderm. For larger donor sites, the bandage will be held in place with
surgical staples. This type of bandage will dry on to the donor site. The
donor site staples may be taken out before you leave the hospital or at your
first post-op visit.
Your surgeon will tell you when you can start getting the donor site wet. This
is often after you have your first post-op visit. If your bandage was left to
dry on to the donor site, you will slowly begin to peel the bandage at the
edges as the new skin under it heals. It may take another 1-2 weeks before the
donor site bandage comes off completely. Your skin will be dry and pink when
the donor site dressing comes off. You will need to apply alcohol free
moisturizer to the skin as it heals.
Oral Care for a Skin Graft in Your Mouth You may be given a mouth wash if your
STSG is within the mouth. This is to keep the mouth and bolster as clean as
possible. Use the mouth wash as directed. You may gently rinse your mouth with
plain water after meals to keep food away from the skin graft.
Pain Control Your skin graft and donor site may be sore for 1-2 weeks. The
donor site is often more tender than the skin graft. A STSG donor site may
feel like a burn. It is less painful if it is kept covered while it heals.
You will get a prescription for opioid pain medicine to use as needed. You may
get a liquid medicine if your skin graft is inside your mouth. This is so it
is easier to swallow.
Take a stool softener to prevent constipation if you use opioid pain medicine.
It may take months to regain some feeling in your skin graft. The feeling will
be different than it was before your surgery.
Activities · Your restrictions will depend on the type of surgery and skin
graft you had done. · No strenuous activities 2-4 weeks. · Avoid activities
that will pull or stress the skin graft. · Do not put any pressure on the skin
graft. · Resume activities slowly over the next few weeks. · Do not lift
anything over 10 pounds for the first 2 weeks.
When to Call · Increased pain around your skin graft or donor site. · Fluid or
blood that collects under a STSG. · The STSG seems to be moving on the wound
where it was placed (it is not attaching to the wound). · A fever over 100.5°
for 2 readings 4 hours apart. · Redness or pus-like drainage around the skin
graft or donor site. · Foul odor · Change in color of skin graft, looking more
pale white, gray or black in color.
Complications You may hear your doctor say that the skin graft “hasn’t taken.”
This may happen for several reasons including:
· Infection · Fluid or blood collecting under the
graft. · Too much movement of the graft on
the wound. · Smoking · Poor blood flow to the area being
grafted.
You may need another surgery and a new graft if the first graft doesn’t take.
Smoking Smoking and nicotine can make it harder for your skin graft to heal.
Do not smoke or use a nicotine replacement for at least 2 weeks before and 4
weeks after surgery.
Sun Protection You must protect your skin from the sun! Your new skin graft or
your donor site will stay darker in color if you burn.
Make sun shielding or sunscreen a part of your daily routine. Sunscreens are
products that absorb sun rays. They protect against scarring and pigment color
changes. The best way to choose a sunscreen is to check the SPF (Sun
Protection Factor number). Use one with an SPF number of 30 or more. Choose a
sunscreen that is waterproof if you sweat a lot or will be swimming. You must
apply a sunscreen 30 to 60 minutes before going out into the sun for the best
results. Apply a good amount and as often as the label tells you to.
Clothes protect against UV rays. You should wear a wide-brimmed hat to shield
your face.
Medicines can make skin more likely to sunburn. Some antibiotics, water pills,
and birth control pills make the skin more sensitive to UV light. Check with
your doctor or pharmacist if you are taking any medicine.
Who to Call Otolaryngology (ENT) Clinic Monday Friday, 8:00 am 5:00 pm
608-263-6190
After hours and on weekends, the phone is answered by the paging operator. Ask
for the ENT doctor on call. Leave your name and phone number with area code.
The doctor will call you back.
Toll-free number: 1-800-323-8942.
Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright © 8/2024 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#8363