Our skin performs essential functions that we don’t even think about most of the time—guarding us from infection, regulating our body temperature, controlling fluid loss. But severe burns, other deep wounds, or illness can destroy the skin’s ability to protect us. Skin grafts—using skin from one part of the body to regenerate growth in another—can be life saving.
Dr. Jensen has done extensive work with patients needing graft surgery, whether to restore skin after a devastating burn or as part of reconstructive surgery following cancer.
Skin Graft Surgery
There are two main types of traditional skin grafts. Split-thickness grafts, involving just the top two layers of skin, are used for shallow wounds. Full-thickness grafts transplant all the skin layers, including blood vessels and sweat glands, so they look and act more like the original skin. These are often used for small wounds in visible areas such as the face.
Skin is taken from an area usually hidden by clothing, such as the upper thigh. A special tool called a dermatome is used to remove the precise amount that’s needed. This skin is then placed over the cleaned wound area and held in place with stitches, staples, or a dressing. Skin grafts are usually done in the hospital under general anesthesia. The hospital stay could be a few nights to a week to make sure the graft is “taking” and is free of infection.
A much less painful alternative to standard skin grafting is now available. A new technique for harvesting a very thin layer of epidermis (the outer layer of skin) can be performed in the clinic without anesthesia. A device called a Cellutome is used to apply gentle suction on the skin, gradually pulling it up through small holes in a plate placed over the skin for about 30 minutes. This outer layer of skin is transferred onto a dressing similar to a Band-Aid, which is applied directly to the wound. This exciting advancement in skin grafting is performed by Dr. Jensen at the Utah Valley Wound Clinic. You can see the story at this link.
Skin Graft Healing
Split-thickness grafts usually heal in about two to three weeks. Scars will remain at both the harvest site and the graft. Split-thickness grafts will take on a paler coloration than the surrounding skin.
Burn and Wound Debridement
For some wounds, removing damaged skin and tissue to allow for healing—without a skin graft—may be appropriate. This is called “debridement.” It is a step in graft or reconstructive surgery, but it is also performed by itself to avoid infection and enhance a wound’s potential to close on its own. Debridement may be used to promote healing for diabetic ulcers, for example. Several methods can be used to clean such wounds, including surgical removal of the unhealthy tissue and treatment with enzymes.