FAQ: Skin Grafting

This surgery will remove healthy skin from a donor site (usually from the buttocks or thighs) and place/stitch it over the area of the skin where the wound resides

Some possible complications/risk are infections, reaction to anesthesia, bleeding, skin graft resisting to heal,  increase or reduce/lost of skin sensation, scarring, discolouration of the skin, and uneven skin surface

Other surgical options can include bioengineered skin, negative-pressure wound therapy, and skin cell gun.

Liposuction and mini-abdominoplasty are procedure similar but usually give lesser result.

My usual procedure is a combination of liposuction tissue at the lateral portion of the abdominal incision and the epigastric region. The excessive abdominal panus (fat) is then removed and the abdominal wall muscle is then tightened. The abdominal wall is then closed.

This usually involves the right to the left anterior superior iliac spine over the pubic region.

The graft will be obtained from another part of your body (commonly thighs and buttocks)

The thickness of the graft will depend on the severity of the damage

Your graft should last a lifetime, as long as the healing process is successful

The chances are slim since the graft is obtained from your skin/body and not from another source

Successful patients usually do not need additional surgery

There is a chance that there may be a loss of sensation in the donor area, depending on the degree of damage

This will vary from patient to patient

Some patients will have minimal scarring while others will have a very distinct and visible scarring

The surgery should take

You will have bandages that will need to be regularly removed and replaced for a couple of weeks, depending on where the location of the treated area is

The grafted area will be red and noticeable with scarring in the beginning, however as time goes by, all these side effects will subside but will still be apparent

The pain will be moderate but medication will be provided to help manage

Because of the technique that I use to close the abdomen, drains and tubes are usually not necessary unless it is of extraordinary situation.

Patients usually do not need physical therapy unless the damage was severe to the point of movement impairment

I usually perform this surgery as an outpatient and every one is able to go home the same day. You will be seen the following day or 2 days later.

You should be able to get back to 80% of your daily activities within one week. I encourage my patients to ambulate and resume light activities within a few days after surgery. You are encouraged to lean over when you are walking. We recommend that you do not do any heavy exercise or weight lift for four to six weeks.

In general, you should not drive the first 48 hours after surgery. Also if you are taking heavy necrotic, one should not be driving. Most of my clients are usually driving after 3 to 4 days.

This depends on the type of work. For people who are doing desk job and love to go back to work, return to modified work after 1 week is very common. For one who has a more physical intense job, one may take 6 to 8 weeks before one returns to modified work.

My procedure is usually done under general anesthesia but spine and region with sedation are also possible.

All my patients see the anesthesiologist before but usually on the day of surgery. For one who has special needs, I frequently arrange for consultation with anesthesiologist a few days before surgery.

I review all patient medications on initial consultation, pre-operative appointment and day of surgery.

I review all patient medications on initial consultation, pre-operative appointment and day of surgery.

In general, all medication that may cause bleeding or prolong bleeding time may need to be stopped or alter. One should not stop any medication without consulting with your family physician and the specialist that put you on these drugs.

For my patients, general lab tests such as CBC, electrolytes, liver function, INR, PTT, cardiogram are fairly routine, Other tests may be ordered if one has special medical condition.

My anesthesiologist and I prefer that one stop eating and drinking 6 hours before surgery. One can take medication with a small sip of water if the medication is indicated before surgery

We recommend that you arrive 30 minutes before your surgery. We will also try you on your mobile phone if the time of surgery has been changed.

You can call my office for direction. Our address is available online and one can also use mobile app for direction

You need someone to take you home after surgery as driving is not permitted.

• Arrange for personal items you might need during your hospital stay
• Arrange for someone to take care of responsibilities at home and work
• Arrange for someone to take you home from the hospital
• Arrange for someone to stay with you the first night after surgery
• Call your doctor if you think of other questions
• Notify your doctor if you get sick within 10 days of your surgery (even minor illnesses like a cold)
• Stop eating and/or drinking as advised by your doctor
• Do not smoke or drink alcohol 24 hours before your surgery
• Make sure you have the doctor’s contact information
• Make sure you have directions to the hospital/office for visitors

• The surgery time can range from 1-2 hours

• You usually wake up within 10 minutes from the procedure, and your family can see you within an hour from the procedure.

• You usually wake up within 10 minutes from the procedure, and your family can see you within an hour from the procedure.

• If you have significant risks of DVT or pulmonary embolus, you will need to take blood-thinning medication.

• I usually start antibiotics in the operating room, and you may take oral antibiotics for another 48 hours.

• Make sure your identity has been confirmed with name and date of birth
• Make sure you have confirmed the surgery you are having
• Make sure the correct site of your surgery has been marked
• Confirm any allergies and side-effects you might have
• Make sure you understand and have signed the informed consent forms
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• I usually talk to you in the recovery room as well as with one to two days after surgery in your postoperative visit to explain how your surgery went.

• This depends on your medical conditions and I will discuss this with you at your pre-operative consultation.

• I usually like you to continue with your usual medication with exception of medication that can cause bleeding. I will discuss this with you further.

• My usual protocol does not use drains, tubes or catheters because I use special closure technique to decrease the needs of these devices.

• You can drink water and liquid shortly after the procedure.

• Breathing exercises after the procedure is improvement and my patients start in the recovery room after they are awake.

• My procedure is usually as an outpatient and you will be staying for a few hours after. I only let my patient go home if they are ready.

• You need to meet all the discharge criteria before you can go home.

• You will be given intra-operative medication; local block and oral and parental pain medication to make sure you are comfortable.

• If needed, you can start physical therapy after a month but this can vary depending on how deep the damage was and where the impairment occurred

• For my patients, general lab tests such as CBC, electrolytes, liver function, INR, PTT, cardiogram are fairly routine, Other tests may be ordered if one has special medical condition.

• Your incision on the donor site should  finish healing after a couple of weeks while the incision for the skin grafting will be distinct and noticeable

• Antibiotics will be started after you finish surgery but your regular medication should still be taken unless advised by your doctor or me

• Our patient can do light activities at home. It is better to walk slowly and avoid any excess contact/rubbing on the surgical area. If the skin grafting is done on the leg, patients are advised to remain in bed for 10 days and keep the treated leg elevated

• You should have the medication filled before the day of surgery.

• Any mediation that can cause bleeding or alternate your medical condition need to be stopped or changed before surgery. I will be discussing with you in detail at pre-operative visit.

• There will be a bandage applied over the wound.  During post-surgery, the patient will be require to change the bandage regularly and apply mineral oil to avoid cracking of the skin

• You can take a shower  two days after the surgery

• I usually like to see my patients the first one to two days after surgery.

• You usually do not need physical therapy. And if you do, this will be discussed with the individual who provides you the physical therapy

• The sutures are usually removed about 10 days after surgery.

• This depends on the amount of contact/rubbing the treated area encounters, usually

• It is suggested that the activity level is low to avoid any excess rubbing or contact with the healing area. Returning to normal activity can range from 1 week to 3 weeks, depending on the type of skin grafting done

• For clients that do light office work, return to work within two weeks is possible, depending on the type of skin grafting. For clients who work in more physical demanding jobs, you can take up to 6 weeks after surgery.

• You can usually drive a couple of days after surgery as long as you are not any narcotic medication and this also depends on the type of skin grafting you had done

• I suggest that you should avoid sexual activity for a few weeks.

• • Make sure your care providers wash their hands before and after your care
  • Do not wait until your pain is severe before you ask for pain medication
  • Make sure the call button is within reach before medical staff leave the room
  • Sit on the edge of the bed for a few minutes before you stand up to prevent getting dizzy

  Do not get out of bed without help if you feel weak or dizzy

• • You have a fever higher than 100.4 degrees Fahrenheit
  • You have shortness of breath or chest pain
  • You notice increased redness, swelling, warmth, or pain around your surgical site
  • You notice that your graft is separating or you have infected discharge from your graft
  • You notice the edges of your skin graft turning dark
  • Your dressing is repeatedly soaked with blood
  • You have pain that your existing pain medications cannot control
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• • • Take pain and other medications as prescribed
    • Do not drive when you are on prescription pain medications
    • Do not soak in a bath or go swimming for ten days after your surgery
    • Keep your graft clean and dry
    • Avoid strenuous exercise and heavy lifting as long as your doctor advises
    • Follow your doctor’s instructions on resuming normal daily activities

    Follow your doctor’s instructions on resuming sexual activity