Name of the Procedure:

Full Thickness Skin Graft, Free, Including Direct Closure of Donor Site, Trunk (20 sq cm or less)

Summary

A full thickness skin graft involves removing a piece of skin from one part of the body (the donor site) and transplanting it to another area that needs coverage (the recipient site). The donor site is then directly closed with stitches. This procedure is typically performed on the trunk of the body and covers an area of 20 square centimeters or less.

Purpose

The procedure is used to cover and repair areas where the skin has been lost due to injury, surgery, or disease. The main goal is to restore the function and appearance of the affected area.

Indications

• Large wounds or burns that cannot heal on their own
• Surgical removal of large skin lesions or tumors
• Sites of chronic ulcers
• Traumatic injuries requiring skin coverage
• Non-healing wounds

Preparation

• Patients may need to fast for several hours before the procedure if general anesthesia is used.
• Pre-operative assessments may include blood tests and physical exams.
• Patients should avoid certain medications, as advised by their healthcare provider.

Procedure Description

1. Anesthesia administration: Either local or general anesthesia is used.
2. Donor site identification: A healthy area on the trunk is chosen where the skin can be harvested.
3. Skin removal: A full thickness piece of skin including the epidermis and the entire dermis is carefully cut from the donor site.
4. Transplantation: The harvested skin is then placed over the recipient site and secured with sutures or staples.
5. Direct closure of donor site: The donor site is closed directly with stitches, ensuring minimal scarring.
6. Dressings: Both the donor and recipient sites are covered with appropriate dressings to protect them and promote healing.

Duration

The procedure typically takes about 1-2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the donor or recipient site
• Poor graft take, leading to graft failure
• Scarring or discoloration at the donor or recipient site
• Pain or discomfort
• Blood loss or hematoma formation

Benefits

• Effective coverage and protection for the wound area
• Improved aesthetics and functional outcomes of the treated site
• Enhanced healing and reduced risk of infection

Recovery

• Follow specific wound care instructions given by the healthcare provider.
• Periodic follow-ups to monitor the healing process.
• Avoid strenuous activities or pressure on the treated area for several weeks.
• Pain management with prescribed medications.

Alternatives

• Split-thickness skin grafts
• Dermal substitutes or synthetic grafts
• Local flaps or tissue expansion

Pros of Alternatives:

• May require less donor skin
• Faster healing for split-thickness grafts

Cons of Alternatives:

• May not provide as robust or aesthetic an outcome as full-thickness grafts
• Risk of different complications, such as needing more frequent dressing changes for split-thickness grafts

Patient Experience

• Patients may feel discomfort or pain at both the donor and recipient sites, which can be managed with medications.
• There might be some temporary restrictions on movement or activities especially around the trunk area.
• Most patients experience a notable improvement in the treated area within a few weeks, with continued healing over several months.