Skin graft, grafting, Humby knife, Aesculap dermatome, wounds, skin loss, injuries, burns, tumors, cancers, plastic surgery India, cosmetic surgery India, Dr Alexander, Cochin, kerala, medical tourism, India+

Sometimes the skin of our body may be lost or damaged and this may happen due to many causes. Commonly, road traffic accidents are the one which result in skin loss. Skin tumors when removed may lead to loss of skin. When burns occur, the skin may be destroyed and lost. Sometimes infections and conditions like necrotising fasciitis can lead to massive skin and tissue loss.  In all these cases the lost skin will have to be replaced. While skin can be obtained from different sources like cadavers and other living persons, (allograft or homograft), animals like pigs (heterograft or xenograft), or even artificial skin like Integra (bovine collagen and silicone layer), it’s the  individual's own skin that is the best sources and match. The take of this graft (auto graft) is good and the cosmetic and functional results are acceptable as well.

The skin has two layers – dermis the deeper one and epidermis the surface layer. Depending in the thickness of the graft taken, the grafts are named differently. There are two types of skin grafts that are harvested- thick and thin, depending on the requirements in a particular case. Small areas of full thickness grafts can be obtained from behind the ear and that area can be closed primarily. This is done by using a scalpel, cutting the skin out and closing the defect. When a large area of skin is needed, then a partial thickness skin graft is harvested from the thigh or other areas. The first picture seen above, shows how a skin graft can be harvested from our body using a Humby knife. Both the Humby knife and the electric dermatome (Aesculap) is shown in the second picture. Sometimes the area of skin graft required is very big and then we find that our donor skin is limited. The skin grafting mesher allows us to expand the skin by cutting it into a mesh like pattern. This also prevents the blood and serum from collecting under the graft and thereby allows good approximation between the wound bed and the graft itself, so the graft will firmly adhere to the wound bed and will not be rejected. The skin graft must get its nutrition and slowly develop its blood supply from the wound bed. This process takes time and therefore post operative care of the graft is very important. A plaster support or splint will help to immobilize the grafted area and prevent shearing of the graft. Once the graft is well adhered to the wound bed, gentle movements may be allowed – usually about 2 to 3 weeks after surgery. The donor site from where the grafts have been taken takes about 2 to 3 week to heal and thereafter will need some cream applications and moisturizers as well. Avoiding sunlight on the operated areas is important as it can lead to hyperpigmentation +