A skin graft is usually needed to cover wounds which can
occur due to trauma, infection, or surgery. High energy fractures may cause
compartment syndrome which will require fasciotomy. Fasciotomy wounds can be
treated by different ways, and one of these ways is a skin graft. In open
fractures, when the wound is extensive, it may require a skin graft. Wounds can be divided into two types: simple
and big. Simple, uncomplicated wounds can usually be closed with sutures or
staples. If the wound is big, the surgeon cannot close the wound. The surgeon
cannot approximate the edges of the wound together. A different method for
coverage of the muscles, and the sound becomes necessary. A skin graft is one
technique used in this situation. The wound is initially treated with wet to
dry dressings or with a VAC (Vaccum Assisted Closure). A VAC is very helpful
because it promotes healing and reduces swelling of the open wound. Before you
obtain a skin graft to cover the wound, the wound will be debrided, cleaned,
and measured. A bulb syringe is usually used for irrigation of the wound. A
skin graft involves cutting a thin slice of skin from a donor area. The skin
sample is commonly taken from the area of the thigh. The skin sample is prepare
before applying it to the recipient site. The donor skin is then meshed, which
will cut tiny slits in the graft, allowing the graft to be stretched for
covering large areas of the wound (this allows for using less skin). The meshed
skin is now ready to be placed over the wound, and staples are used to
adequately secure the skin graft to the wound. Be careful not to put the
staples into any neurovascular structures. Skin grafts are very fragile, and
great care must be taken when looking after them, even after the wound has
healed. Therefore, sterile dressing is applied to the wound and should remain
in place for approximately 5 days. During the first dressing change, the
clinician will slowly remove the bandages and normal saline may be used to
moisten the dressing in order to avoid damaging the skin graft. The wound is
inspected for signs of infection. Covering the wound early may help in
preventing infection.
