Our Summary

This research paper looks at a common treatment for severe burns, called split thickness skin grafting. This involves taking a thin layer of skin from a healthy part of the patient’s body (the donor site) and grafting it onto the burn wound. Sometimes the skin graft is meshed or expanded to cover a larger wound area.

The researchers studied the medical records of 210 burn patients treated at Vancouver General Hospital between 1998 and 2014. They also surveyed plastic surgeons across Canada to find out their usual practices for treating severe burns.

The study found that patients who received heavily meshed grafts (a meshing ratio of 3:1 or higher) usually had flame burns and larger burn areas. The decision to use a higher meshing ratio was mainly influenced by the size of the burn, and to a lesser extent, the location of the burn. The location of the burn also determined where the skin graft was taken from and where it was placed.

In other words, the larger and more severe the burn, the more likely surgeons are to use a technique that allows them to cover more area with less skin.

FAQs

  1. What is split thickness skin grafting and when is it used?
  2. How does the size and location of the burn affect the decision to use a higher meshing ratio in skin grafting?
  3. What factors influence where the skin graft is taken from and where it is placed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about skin graft surgery is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of infection. This may include keeping the graft site clean and dry, changing dressings as instructed, taking prescribed medications, and avoiding activities that could disrupt the healing process. Additionally, it’s important to attend follow-up appointments with your healthcare provider to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for skin graft surgery include those with severe burns, especially flame burns, and larger burn areas. The decision to use skin grafting is influenced by the size and location of the burn, with larger and more severe burns more likely to require skin grafts. Additionally, patients with burns that are difficult to heal using other methods may also be recommended for skin graft surgery.

Timeline

Before skin graft surgery:

  • Patient sustains a severe burn injury
  • Patient is evaluated by a medical team to determine the extent and severity of the burn
  • If the burn is severe enough to require skin grafting, the patient undergoes preoperative preparation, including wound care and stabilization
  • A suitable donor site for the skin graft is identified on the patient’s body
  • The patient undergoes anesthesia and the skin graft surgery is performed
  • The skin graft is applied to the burn wound and secured in place
  • The patient is monitored for any complications and kept in the hospital for postoperative care and recovery

After skin graft surgery:

  • The patient continues to receive wound care and monitoring to ensure the skin graft is successful
  • The patient may experience pain, swelling, and discomfort at the donor site and graft site
  • The patient may need to undergo physical therapy or occupational therapy to regain function and mobility in the affected area
  • The patient may require follow-up appointments with the medical team to assess the healing progress of the skin graft
  • Over time, the skin graft should integrate with the surrounding tissue and provide coverage for the burn wound
  • The patient may need to undergo additional surgeries or treatments depending on the outcome of the skin graft surgery

What to Ask Your Doctor

Some questions a patient should ask their doctor about skin graft surgery include:

  1. What is the extent of my burn injury and why do I need a skin graft?
  2. What type of skin graft technique will be used in my case (e.g. split thickness, full thickness, meshed graft)?
  3. What are the potential risks and complications associated with skin graft surgery?
  4. How long will it take for the skin graft to heal and what is the expected outcome in terms of scarring?
  5. Will I need multiple surgeries or follow-up procedures after the skin graft surgery?
  6. What are the post-operative care instructions for my skin graft site?
  7. How can I manage pain and discomfort during the recovery period?
  8. Are there any restrictions or limitations on my activities during the healing process?
  9. How long will it take for me to return to my normal daily activities and work?
  10. What are the long-term implications of having a skin graft, both physically and psychologically?

Reference

Authors: Pripotnev S, Papp A. Journal: Burns. 2017 Dec;43(8):1775-1781. doi: 10.1016/j.burns.2017.04.024. Epub 2017 Jun 9. PMID: 28602593