A skin graft is required when a burn is deep or if the wound has not healed within two to three weeks. The optimal benefits of a skin graft are that it closes the wound, improves mobility and the long-term appearance of the scar.
What is a skin graft?
A skin graft involves removing a thin layer of skin from an area of the body, such as the thigh or buttocks, and placing it over a new bed of healthy tissue under a burn. This skin then adheres to the wound. The area where the skin is taken from is called the donor site. The location and size of the graft determines how it will be secured, for example with staples, stitches or surgical glue.
What is debridement?
Debridement is a procedure that is used to remove the dead skin (or eschar) from the burn area. This procedure is performed under a general anaesthetic in an operating theatre. The burnt area is removed to expose healthy tissue to which the skin graft will be secured.
If your child is scheduled for debridement and grafting in the morning, please ensure they do not eat or drink anything after 2am. If they are having their operation in the afternoon, please ensure they do not eat or drink after 7am.
The donor site
The donor site looks and feels like a graze (or gravel rash) and can be quite painful for up to 48 hours. The area generally takes 7 to 14 days to heal. The colour will fade but may remain pink for up to six months after grafting.
The grafted area and the donor site will be bandaged for seven days. If the skin graft crosses a joint, a splint (a moulded plastic device) may be used to stabilise the limb in its correct position while the graft heals.
It’s important to keep the dressings clean and dry at all times. Your child should not play in sand or dirt as this can get under the dressings and cause irritation or infection and possibly damage the graft.
You should sponge bath your child, rather than bathing or showering to avoid wetting the dressing(s) accidentally. If the dressing(s) do get wet, contact the Centre to arrange further dressing as soon as possible.
Care of the donor site
The donor site is covered with a special dressing that absorbs any wound/fluid ooze and aids healing. This is left in place for seven to 10 days. If there is excessive ooze or bleeding from the wound site, return to the hospital. If your child gets any urine or faeces on the dressing, clean it off as best as you can.
Contact the Burns Unit if:
- the splint falls off, or slips out of place;
- dressings fall off, leaving the raw area exposed;
- the bandages become wet or dislodged; or
- your child develops a fever, feels unwell or extremely uncomfortable.
Your child may require regular pain relief (every four to six hours when awake) for two to three days after discharge from hospital. If your child is experiencing pain that is not relieved by medication such as paracetamol, contact the Burns Unit or bring your child to the Emergency Department of the Queensland Children’s Hospital.
Burns Outpatients Unit (5e)
Queensland Children’s Hospital
Level 5, 501 Stanley Street, South Brisbane
t: 07 3068 2830
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.