The Split-Thickness Skin Graft

This information describes surgery using a split-thickness skin graft.

In a split-thickness skin graft, your surgeon removes a thin layer of skin from one part of your body (called the donor site) and uses it to close the surgical site that needs to be covered (called the recipient site). You may have a split-thickness skin graft if you lost a large area of skin at your surgical site.

Donor Site

Your donor site will be chosen based on the size of the area that needs to be covered. Your surgeon will show you the area(s) that may be used as a donor site. Common sites are the upper thigh and buttock. You will be able to talk about it during your clinic visit before your surgery.

After the skin graft, your donor site will look raw and you may experience some mild discomfort or pain in the area.

Your donor site will be covered with one of the following in the operating room:

  • Xeroform® (sterile wound dressing) and a dry gauze
  • Kaltostat® (a padded off-white dressing) under TegadermTM (a clear dressing)

If you have a Xeroform dressing, gradually trim and remove the dressing as it loosens. It may take several days for the dressing to loosen. Ask your doctor or nurse when you can begin to apply A & D® ointment directly on your donor site. This will be after the site is no longer raw.

If you have a Kaltostat and Tegaderm dressing, your doctor or nurse will change the dressing 2 to 3 days after your surgery. If the donor site is healed on the 7th day after your surgery, the area will be left open to the air. If the site is not completely healed, a new Kaltostat and Tegaderm dressing will be applied to the site.

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Recipient Site

Your recipient site may be covered with a pressure dressing or a wound VAC system.

Pressure dressing

If you have a large pressure dressing (called a bolster), it will be placed over your recipient site in the operating room. It will help to make sure that your site heals properly. The pressure dressing may be held with silk stitches, a splint, cast, or sling. This prevents your graft from moving. Your surgeon or nurse will remove the pressure dressing to evaluate your skin graft about 5 to 7 days after your surgery. After the pressure dressing is removed, your recipient site will be covered with a Xeroform dressing.

If you have a cast, a “window” will be made in the area of the cast above your recipient site. This allows your surgeon to examine your graft. The entire cast will be removed 10 days after your surgery, unless you have had other surgeries. If you have had other surgeries, you may have to keep the cast on longer. An Ace® bandage or tape will be used to hold your dressing in place after your cast is removed.

After your doctor or nurse looks at your recipient site, he or she will cover it with a lubricated dressing and dry gauze. You may be instructed to change this dressing daily until your graft has completely healed. Your nurse will teach you and a caregiver how to change the dressing.

Wound VAC system

Instead of a pressure dressing, your surgeon may choose to use a wound VAC system on your recipient site. A wound VAC is a special dressing that applies suction to your wound to improve healing.  It will also be removed 5 to 7 days after your surgery. Your surgeon will then examine the graft.

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Caring for Your Sites

  • You should keep your donor and recipient sites clean and dry until your healthcare provider has told you that it is ok to wash the areas. This will be based on how fast you sites are healing.
  • You may have some clear yellow or pinkish drainage from your donor site. You can place a dry gauze over the dressing on the donor site.
  • After your donor and recipient sites have healed, apply a think layer of A & D ointment or other moisturizer to the area. Do this once a day after showering and keep the sites exposed to the air as much as possible while you are at home. If needed, you can apply dry nonstick gauze over the sites when you are not home.
  • Do not rub the sites until they have completely healed.
  • Avoid exposing the sites to the sun. Once the sites have completely healed, apply a PABA- free sunscreen with an SPF of 30 or higher to the surgical sites.
  • At first, your recipient and donor sites will look dark pink in color. This color will gradually change and become lighter over several months. Once your sites have completely healed, you can use makeup to cover them.
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Call Your Doctor or Nurse if You Have:

  • A temperature of 101° F (38.3° C) or higher
  • Shaking chills
  • A thick yellow or a foul smelling drainage from your donor or recipient site
  • New or increased redness or warmth around either site
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