Burn Injury Resource Center
Skin flap is a surgical procedure in which a healthy skin and its underlying subcutaneous tissue is taken from an area very close to the wound to be covered, the flap remains partly connected to its original site via its blood supply.
Skin graft is the surgical procedure in which a non healing wound or a burn wound is covered by a piece of healthy skin taken either from the patient or from a cadaver or an animal; the graft taken does not have its own blood supply and is completely separated from its original site . Skin graft is either used a temporary wound cover or a permanent one. Some wounds such as third degree burns if left to heal on their own can lead to scarring and contractions.
As the skin is the largest organ in the body and among its functions is playing a major role in protecting the body from fluid loss and help in preventing harmful micro organisims such as bacteria and viruses from entering the body and causing infections therefore its important to cover third degree burns with skin graft as soon as possible as uncovered third degree burns are more liable for wound infections and fluid loss from the burn area .
Skin graft is not used for wounds that can heal on itself such as first and many second degree burns, it’s used for large and non healing wounds. The skin used for grafting can be taken from another area of the patient body if there is enough undamaged healthy skin available and if the general condition of the patient permit to undergo an additional surgery. This type of graft is call Autograft. Another type of skin graft is called Allograft where the skin is obtained from another person who is usually a donor cadaver in which the skin is frozen and stored to be available for use. The last type of skin graft is called Xenograft where the skin is obtained from an animal which is usually a pig. Autograft can be used as a permanent covering to the damaged area while Allograft and Xenografts are temporary ones as they will be rejected by the immune system of the patient after a short period of time and need to be replaced by Autograft.
Skin grafts can also be classified according to the thickness of the graft as Partial (split) thickness skin graft and full thickness skin graft. Split thickness skin graft is used for wounds which are not very deep where the epidermis and a small thickness of the dermis is used, the graft receiver area usually heals within several days. Full thickness autograft skin graft involves both the epidermis and dermis, it provides less contraction and better contour at the recipient site but the wound at the donor site will be larger, requires more medical attention and often needs a split thickness skin graft to cover it.
Skin graft need to be taken care of for several months with Ace bandage or stocking even after healing to decrease the risk of contracture. Patients with grafts on their legs need to stay in bed for several days for the grafts to heal. Grafts should be kept moist and be lubricated daily for two to three months with a bland oil such as mineral oil to prevent dryness, itching and cracking of the area as the grafted skin does not contain sebaceous (oil) glands or sweat glands. As with any surgical procedure, skin graft surgery risks my include infection, bleeding, anesthesia complications and graft failure. A successful graft provides a great improvement in the burn wound quality and can may prevent serious burn wound complications such as infections and contractures.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.