The skin is the largest organ of the human body, and plays a critical role in protecting underlying cells and tissues from physical damage and infection by pathogens. The risk of infection and trauma to the body caused by skin burns is significantly reduced when treatment programs such as skin grafting are undertaken, according to the website Burn-Recovery.
Autografts
The patient's skin is the best source for grafts as it will not be rejected by the body's immune system, and this procedure is known as autografting. Sites where skin has been removed do not look the same, even when fully healed, and for this reason autografts are usually taken from less-visible regions of the body, such as the buttocks or upper thighs. Sometimes burns are so severe that sufficient areas of undamaged skin are not available and other options must be pursued, according to a review published in "Wounds" in November 2007.
Cell Cultured Epithelial Autograft
Another option, in cases where autograft is not possible, is to take skin cells from the patient and culture them in the lab. When cultured in this manner, skin cells only grow a few cell layers thick, and the subsequent skin grafts will not stand up to trauma. However, the advantage of this technique is that the body will not reject a graft generated from the patients cells, according to an article published in "Burns" in April 2007.
Skin Removal and Grafting
A special instrument called a dermatome is used to remove the top layer of skin, known as the epidermis, and a portion of the second layer, referred to as the dermis. The graft is then placed over the burned area and held with surgical stitches or surgical staples. The skin autograft is nourished by the underlying blood plasma, and new blood vessels begin to grow within 36 hours of the graft, according to Regions Hospital.
Negative Wound Pressure Therapy
Graft healing is usually facilitated by a technique known as negative wound pressure therapy, in which a piece of foam is cut to the size of the wound, and a perforated tube layered into the foam. A vacuum pump is attached to the tube, which creates negative pressure, fixing the foam over the wound site, draining excess blood and fluid, maintaining cleanliness and promoting growth of new blood vessels, according to a study published in "Annals of Plastic Surgery" in June 1997.
Prognosis
The vast majority of skin grafts are successful, but in a minority of cases the region does not heal and repeat grafting is required. Patients should avoid exercise that may shift or stretch the graft for one to two weeks, and the graft protected from trauma for a further week, according to the MedlinePlus.
