Discharge Instructions for Your Split Thickness Skin Graft Site
A skin graft is healthy skin that is used to replace damaged or missing skin. The graft is taken from another part of your body. This is called the donor site. You will need to care for both the graft and donor sites as instructed so they heal properly. Follow instructions carefully. It will take 2 to 4 weeks or longer for the graft to completely heal. This varies from person to person and may depend on the size of the graft.
Your skin graft will have a bandage (dressing). Underneath the graft bandage you may have a “bolster.” This is a padded covering secured to the surrounding skin with stitches. The bolster holds the skin graft in place. Or you may have a vacuum bandage, also called negative pressure dressing. This bandage has a thin, flexible tube attached to a small machine. The machine removes air from under the bandage. This can reduce swelling and speed healing. Your bandage will be first changed after 4 to 7 days. The donor site will have a thin bandage. You will not have a bolster or vacuum bandage on the donor site.
General home care
Plan to rest at home for up to a week after the surgery.
Expect some light bleeding, swelling, bruising, redness, and discomfort.
If you were given prescription pain medicine, take it as instructed.
Follow any other instructions you were given.
Caring for the bandaged graft site
Do not touch the bandage. Leave it in place until you are told to remove or change it.
Keep the bandage dry. Take a sponge bath to avoid getting your bandage wet, unless your healthcare provider tells you otherwise. Ask your provider about the best way to keep your bandage dry when bathing or showering. Ask your provider what to do if your bandage gets wet.
Keep the bandaged area clean. Avoid getting dirt or sweat on it.
If the bandage comes off or is damaged or very dirty, call your healthcare provider.
If the tube on your vacuum bandage comes off, call your healthcare provider.
As often as possible, elevate the graft site above the level of your heart. Do this when sitting or lying down. This helps reduce swelling and fluid buildup in the graft area.
Keep the part of the body with the graft as still as possible. Avoid any movement that stretches or pulls the skin graft.
If the graft bleeds, apply gentle but firm pressure to the graft site with a clean cloth or bandage for 10 minutes.
Caring for the bandaged donor site
The donor site will have a thin bandage. Do not touch the bandage. Leave it in place until you are told to remove or change it.
Fluid will leak from this area. This is normal.
If the site becomes swollen or is hot or painful, call your healthcare provider.
Your bandage will be removed 7 to 10 days after surgery.
After the bandage is removed, the site will be pink. Over time it will return to more normal color.
You can increase your activity a little bit each day. While you are recovering:
Do not do any activity that stretches or moves the skin graft for as long as advised by your health care provider.
Do not drive while you are taking prescription pain medicine.
Ask others for help with chores and errands.
Bathe or shower according to your healthcare provider’s instructions.
Ask your healthcare provider when you can return to work.
During your follow-up visits, your doctor will check how you’re healing. If you have sutures, they may be removed 1 to 2 weeks after surgery. Your graft site bandage will be changed 4 days to 7 days after surgery. It will be removed 2 to 3 weeks after surgery. You may have smaller bandages over time as the site heals. Your graft site may have areas that turn dark blue or black. This means that this part of the graft tissue has died. It is common for this to happen in small areas. Your healthcare provider will tell you how to care for this area if needed.
After your bandages are removed
After the bandage is removed, the skin graft may look crusted and discolored. This is normal. The skin graft will change color over time. It may look very red for 2 to 3 months. During this time:
Do not scratch, pick at, or touch the graft site or donor site.
Keep the skin moist in these areas. Apply nonmedicated skin lotion often during the day. Do this for 3 to 4 months or as advised.
Do not soak the skin graft site in water. Ask your healthcare provider about the best way to keep the skin graft dry when showering for 1 to 2 weeks. Do not take baths for 2 to 3 weeks.
For 3 to 4 weeks, avoid any exercise or movement that stretches the skin graft.
Protect the skin graft and donor site from the sun for 12 months. Wear clothing over them or use a sunscreen lotion with an SPF of 30 or higher.
Do not rub, scratch, or injure the graft site in any way.
Do not pick at scabs. They help protect the wound and help in healing.
Follow all other instructions from your health care provider.
When to call the healthcare provider
Call your doctor right away if you have any of the following:
Fever of 100.4°F (38°C) or higher
Pain that gets worse or doesn’t go away
Bleeding of the graft that can’t be stopped by applying pressure
Signs of infection, including increasing swelling or redness of the graft, white or bad-smelling discharge from the graft, red streaks from the graft site, or pus at the wound site
Edges of the graft site that start to open up
Any other signs or symptoms indicated by your healthcare provider
March 21, 2017
Basic Principles of Wound Management, Up To Date, Principles of Grafts and Flaps for Reconstructive Surgery, Up To Date
Freeborn, Donna, PhD, CNM, FNP,MMI board-certified, academically affiliated clinician