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In skin grafts, what happens to the place where they took the skin from?
January 14, 2007 5:03 PM   Subscribe

When they do skin grafts on people, doesn't it just leave an equivalent 'hole' wherever they took the skin from? How does that work?
posted by chrismear to Health & Fitness (9 answers total) 3 users marked this as a favorite
 
Skin stretches, dude. They cut the patch of skin off, then they stretch the borders of the "hole" until the skin comes together close enough to stitch up. Picture a hole in your jeans, taking the remaining fabric, pulling it together over the hole, and stitching.

I'm sure there's gory pictures on the web if you google.
posted by Mid at 5:18 PM on January 14, 2007


It's actually a little bit more involved than what Mid describes, although that is part of the answer. For a more detailed explanation:

There are two basic types of skin grafts (not counting cadaver, animal, or cultured grafts, since the donor site is not really a concern in those instances). Full thickness and partial thickness. Full thickness grafts are just as the name implies, the full thickness of the skin. They are typically taken in smaller sizes, and the donor sites are closed by streatching the skin as Mid described. The second type are partial thickness, in which the skin is shaved off with a dermatome to get a large, flat sheet that heals up basically like a large scrape.

In both cases the graft is them put through a meshing machine that slices it to look like a net; the graft can then be stretched to cover an area many times the original graft as the skin cells from the graft grow and migrate outward to fill the holes in the "net". If you have ever seen skin that was grafted you may have noticed the net-like appearance. A more detailed description with pictures that really aren't that gory (at least to me) can be found here.
posted by TedW at 5:35 PM on January 14, 2007


There are skin grafts where a one for one piece is transplanted, but there are also cultured skin grafts (sad photo inside) where small portions of skini (a centimeter squared) are used to culture skin cells and create new skin which is transplanted onto the patient. It was featured on the How Things Are Made show on Discovery a few weeks ago.
posted by furtive at 5:36 PM on January 14, 2007


To make more graft, they may, in fact, pre-stretch the skin where the graft is to be taken from, by inserting and inflating subcutaneous "balloons" -- provided the lead time (a few weeks) to do so is available.
posted by Rumple at 5:37 PM on January 14, 2007


Yes, I've seen some high-profile news articles in past years where they do the thing Rumple says -- notably in siamese-at-the-head seperations -- where they will inflate a baloon-thing near the future surgery site to make an extra expanse of skin in the region so that when it's done, they don't have to graft over. Had no clue about the netting idea.. clever.
posted by Quarter Pincher at 7:58 AM on January 15, 2007


great answers. For an amazing historical perspective go see the early years of grafting at the Hunterian Museumin London. The history of Plastic surgery is fascinating especially since East Grinstead was the area for burns and plastics due to its proximity to the coast ( pilots crash-landing from BoB dogfights). Go upstairs in the Hunterian to see how they grew a nose for one pilot by graft of the tiny piece of remaining viable tissue to his shoulder!
Even today that unit continues to do world-class work particularly in bone-grafts and orthognatics.
posted by Wilder at 8:15 AM on January 15, 2007


oh, and as for the "hole", it's true to say that many people find the donor site a lot more of a problem than the graft.
posted by Wilder at 8:17 AM on January 15, 2007


Thanks, everyone.

The Hunterian Museum looks fantastic; that is now so on my to-do list.
posted by chrismear at 8:43 AM on January 16, 2007


God you're so full of shit Chrismear, you've been saying that for 6 MONTHS
posted by Wilder at 9:24 AM on July 28, 2007


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