wound care instructions for skin grafts
Basically, skin grafting is the transplantation of skin to another location of the body to cover a surgical defect. This implies there will be two surgical wounds (the donor site & original surgical wound). Instructions to care for both sites are provided below.
- Please leave the bandage in place for at least 24 hours following surgery. The bandage should be kept dry during this time. For pain/discomfort, try Tylenol first. Dr. Cowan may prescribe a stronger pain medication if necessary. Try to avoid aspirin, ibuprofen (Motrin), and naproxen (Aleve) for the first 24 hours following surgery as they may increase the risk of post-operative bleeding.
- Clean the wound 2-3 times per day with baby shampoo. Cover the wound (bandage) but do not use ointment (keep dry). Paper tape is best used to secure any bandages.
WHAT TO EXPECT AFTER SURGERY
All wounds heal best when kept clean, moist and covered. The following steps will promote optimal wound healing and yield the best cosmetic result:
- Once directed by our staff, you may carefully remove the bandage, but do so slowly, so not to disturb the surgical site. Clean the graft at least 2-3 times per day with mild soap and water or a mixture of equal parts hydrogen peroxide and water using a Q-tip. Always begin in the center of the graft and gently roll toward the edges of the wound. NEVER use a rubbing or side-to-side motion to clean the area.
- Apply a thin layer of mupirocin(topical antibiotic) to the graft and immediate surrounding area. Ointments prohibit the formation of a thick scab which delays the healing process. You may also be asked to cover the graft with Vaseline gauze. This maintains the moisture barrier and provides additional protection to the site.
- Cover the graft with a non-adherent dressing (Telfa) or large Band-Aid. Be sure the entire graft is covered. For extra protection, cover the non-stick dressing with a layer of gauze. Paper tape is best used to secure any bandages. Tape or gauze should never touch the graft directly.
- All grafts MUST be covered at night, until otherwise directed, to minimize unintentional trauma that can occur while you sleep. Additional gauze and tape should be used to secure the bandage and protect the graft.
Continue the above regimen until otherwise instructed by our staff.
- The skin graft may appear dark in color, varying from purple to black, after the initial bandage is removed. This is normal, and the discoloration will decrease in intensity as the area heals. Applying a thick layer of ointment will help prevent scab formation. If a thick scab or crust forms over the area, it is important not to disturb the area. It will eventually peel or flake off with no assistance.
- You will be notified when it is permissible for water, soap and/or shampoo to run over the graft site. It is critical during this time to minimize any possible trauma to the site. This includes accidental displacement that can occur during the cleaning or bathing process.
- It is normal to have redness at the site after a procedure. However, if the redness spreads or if there is increased drainage from the wound, please contact our office. This may be a sign of infection.
- Hydrogen peroxide
- Cup (to mix half & half with warm water and hydrogen peroxide)
- Q-tips or gauze (wet them in the peroxide/water solution and gently clean the wound)
- Mupirocin 2% ointment (prescription topical antibiotic provided by Bowling Green Dermatology)