Skin Grafts For Treating Burns

Skin grafts for burns are vital components of burn care, particularly for patients with severe burns. These surgical procedures involve transplanting healthy skin from one part of the body (called the donor site) to cover a burn wound or area where lost skin cannot regenerate on its own. This process helps close wounds, promote healing, and prevent infection while improving the appearance and function of the injured area.

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Understanding Skin Grafts

A skin graft is a thin layer of skin taken from a healthy part of the body and placed on a damaged area. Skin grafting is crucial when the body cannot heal large or deep wounds by itself. Commonly, skin grafts are used to treat severe burns, particularly those affecting a large body surface area. By covering the burn injury with donor skin, the grafted skin helps the wound heal faster, preventing infection and minimising scarring.

Types of Skin Grafts

There are two main types of skin grafts used in burn treatment:

Split Skin Graft (SSG): This type involves the removal of the top layer (epidermis) and a portion of the deeper layers (dermis) from the donor site. Split-thickness skin grafts are commonly used for larger burns because they cover extensive areas. The thin shaving of skin can be turned into a meshed skin graft to cover a larger wound, allowing for stretching surrounding tissue and better coverage of large burn wounds. After surgery, the wound heals as the tiny blood vessels grow into the graft and supply it with blood, helping it integrate into the surrounding skin.
Full Thickness Skin Graft (FTSG): In contrast to split-thickness grafts, full-thickness skin grafts involve removing both the epidermis and the entire dermis from the donor site. This type of graft provides better cosmetic outcomes because it matches the texture and colour of the surrounding tissue more closely. However, full-thickness grafts are typically used for smaller areas, such as the face or hands. Where the burn injury affects deeper layers, a full-thickness skin graft may be the best option.

The Skin Grafting Process

As with any plastic procedure, skin graft surgery requires a thorough pre-operative assessment. During the assessment, the plastic surgeon will give details regarding the plan for your surgery, where the skin donated for the graft will be taken from, and how much bed rest you need post-treatment.

During skin graft surgery – usually done under local anaesthetic – the burn wound is cleaned to remove dead tissue and debris. Then, the surgeon harvests healthy tissue from a donor site, often located on the upper thigh, buttocks, or upper arm. After transplantation, the graft site is secured with sutures or staples, ensuring it stays in place until newly healed skin forms and the graft integrates into the original blood supply.

Healing Process and Recovery

Once the graft is applied, both the donor site and graft site require careful monitoring. The healing process depends on the type of graft, the size of the burn, and the patient’s overall health. Split-thickness skin grafts tend to heal faster, but full-thickness grafts often provide better long-term cosmetic results. For the first couple of weeks, patients will need regular dressing changes, and assessments.

The healing time varies, but in general, expect several weeks of recovery, especially for large wounds. During this period, avoid accidental bumps or other forms of trauma to the grafted area.

Also, protect newly healed areas from sun exposure, which can lead to permanent tan or discolouration. Using protective clothing and sunscreen and following instructions for scar management can significantly improve the appearance of scars. Gentle bathing, followed by patting the area dry and applying non-perfumed cream, helps keep the skin hydrated. You must check with your plastic surgeon or the after-care team regarding what is suitable for the wound.

Complex Grafting Techniques

In some cases, flap surgery or tissue expansion may be necessary to treat extensive burns. Tissue expansion involves the use of a balloon-like device called an expander, which is placed under the skin near the burn area. Over time, this device is gradually filled with saline to stretch the surrounding tissue, providing extra skin for grafting. Composite grafts, which include skin and underlying tissue, may be used in more complex reconstructive surgery to restore function and appearance.

Advancements in tissue engineering also offer potential alternatives to traditional grafts. In some cases, artificially grown skin cells or bioengineered skin substitutes are used when there isn’t enough healthy skin for grafting.

Managing Burn Recovery and Long-Term Care

For successful recovery, patients must follow a healthy, balanced diet, avoid passive smoking – passive smoking slows the healing process – and get plenty of rest. In some cases, a blood transfusion may be necessary if there is significant blood loss during the procedure. Maintaining newly healed areas with proper skin care, including the use of non-perfumed moisturising cream, is key to preventing delayed healing and complications like wound breakdown.

A dedicated burns or scar management team will work with the patient throughout recovery to monitor healing and prevent complications.

Skin grafts for treating burns are a lifesaving and crucial intervention, helping patients recover from severe burns and regain normal function. The healing process requires close monitoring of both the donor and graft sites and comprehensive aftercare to reduce scarring and enhance the overall outcome. With the guidance of a specialised burns team and modern surgical techniques, burn patients can achieve an improved quality of life through skin grafting.

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Goutos London
152 Harley Street
London
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Louise Steel

2023-08-16

Mr Goutos performed keloidectomy surgery on both my earlobes, and I am so grateful to have been referred to him. From the first consultation, through surgery, and now my 3-month follow-up, I have nothing but good words to say.

Luke Ward

2023-07-10

This man is an extremely intelligent, professional gentleman. He will set realistic expectations from the beginning and will not ‘beat around the bush’ so-to speak. From the initial consultation to post-surgery, it has been a rollercoaster ride. However the high level of expertise & professionalism Mr Goutos maintained has been impeccable. All I can say to any other individual considering treatment with Mr Goutos, is that you are in incredibly safe hands. And on top of this, he has a great sense of humour. I wish nothing but the best for this man, and the best results for his future patients.

Mauricio Lucas

2023-07-06

Outstanding Doctor - Exceptional Expertise I recently had the pleasure of consulting and also going through surgery. Dr. Goutos removed a large class of keloids from my back and chest, and without a doubt, I can confidently say that he is the best doctor I have ever had the privilege of seeing. From the moment I entered his practice, I was immediately struck by his professionalism, knowledge, and exceptional bedside manner. Dr. Goutos possesses an extraordinary level of expertise in his field, and his technical skills are truly remarkable. His ability to diagnose and treat medical conditions is unparalleled, and I have personally witnessed his remarkable success in improving the health and well-being of countless patients. What sets Dr. Goutos apart is his genuine care and concern for his patients. He takes the time to listen attentively, ensuring that he understands every aspect of the medical issue at hand. He communicates clearly and effectively, explaining complex medical concepts in a way that is easy to comprehend, which greatly helps in alleviating any concerns or fears. One aspect that impressed me greatly was Dr. Goutos' commitment to staying updated with the latest advancements in his field. He incorporates cutting-edge techniques and treatments into his practice, ensuring that his patients receive the highest standard of care available. This dedication to continuous learning and improvement is a testament to his unwavering dedication to his profession. Additionally, the support staff at Dr.Goutos' practice deserves recognition for their exceptional service. They are friendly, compassionate, and highly efficient, ensuring that appointments run smoothly and patients feel comfortable throughout the entire process. Overall, I cannot emphasize enough how fortunate I feel to have found Dr.Goutos' exceptional skills, genuine care, and unwavering commitment to his patients make him a truly outstanding specialist. I wholeheartedly recommend him to anyone seeking top-notch medical care.

Kashmala Khan

2023-01-26

Mr. Goutos and his team did an amazing job reversing a scar I had on my forehead. This was a very old scar and had bothered for many years. The laser treatment and fat transfer procedure has changed my life and given me so much confidence. I would definitely recommend him, he is a fantastic and very skilled surgeon. Thank you so much!

Javier

2023-01-14

Mr Goutos and his team removed some lipomas from my arms. The initial consultation right through to the aftercare was professional, sensitive and genuine. Mr Goutos put me at ease right from the start, discussing my history and background and then discussing the various options for the incisions and sutures. The incisions were quick, efficient and professional. I felt completely at ease knowing I was in expert hands. The incisions were extremely neat and have closed and scared really well. I had a number of questions after the operation and one of the sutures became infected. Mr Goutos was quick to make an appointment for me, see me and deal with the infection and offered for me to see him again if the infection didn’t calm down. He was genuinely empathetic to my needs and took time to check each scare, explain things and assure me along the way. He didn’t at any point, make me feel I was asking silly questions or too many. I highly recommend Mr Goutos for his exceptional incisions and suturing as well as his professional conduct, caring approach and after care. The whole experience was smooth and easy and I am very grateful for what he has done for me.

Ieva Lihovida-Yarlett

2022-12-07

We came to see Dr Goutos a few month ago to remove invasive spider nevus on my 9 year old sons nose . After a lovely consultation with Dr Goutos , he suggested to do several laser treatment sessions. After a few sessions we already noticed a massive improvement. On the final laser treatment session the spider nevus was completely gone. Thank you to the Dr Goutos for tackling the problem so rapidly and with great results!

Amy Munson

2022-10-27

We took our 4yr old daughter to Mr Goutos following an accident which resulted in a small burn scar on her cheek. Mr Goutos gave us various options and we went for laser treatment. After 4 appointments the scar has gone! The care that Mr Goutos gave us was exceptional and so good with children. He made us feel very comfortable and confident in his ability. I would recommend him to anyone if they were looking for a doctor in that particular field. Can't thank him enough.