Skin grafts cover injuries, which would fail to heal without medical intervention. The graft can be from the patient, a donor, or a synthetic substitute. Grafts from patients use an area of healthy uninjured skin (donor site), which is grafted onto the injury. There are two forms of skin graft based on the amount of dermis used: split thickness skin grafts (thin layer of dermis) and full thickness skin grafts (large amount of dermis).
Surgical Complications
All surgical operations have risks either from the anesthetic or the surgical procedure. Infections can occur in patients with a compromised immune response or those with delayed healing such as diabetics. Blood can collect in a hematoma under the graft or at the donor site, which can result in infection or failure of the graft to take.
Cosmetics
The appearance of the graft depends largely on the graft. Split thickness skin grafts can contract, which can result in functional problems if used over joints. They often result in a shiny, smooth surface that can also have abnormal pigmentation, being either too pale or darker than the surrounding skin. Skin grafts can lack hair follicles and sweat glands, which not only alter appearance but may result in dry flaky skin.
Failure of the Graft
The graft must incorporate into the wound. This requires a blood supply that brings nutrients and oxygen to the graft and this blood supply originates from the wound bed. The graft may fail due to infection or other processes that influence wound healing, such as smoking or poor nutrition.
Skin Substitutes
Skin substitutes can be obtained from animals (often pigs), cadaveric donors, and synthetic substitutes. It is also possible to grow the patient's cells in a laboratory, and expand cell numbers to allow coverage of the injured area. The use of substitutes from donors or synthetic substitutes may cause an immune reaction and result in rejection. Further, the use of animals or animal products carries the risk of infections being transmitted to the patient.
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