A skin graft or transplantation procedure is done in cases where the protective covering that is skin is lost due to major burns, cancer surgery, skin infections, large wounds. It is a surgical process in which damaged, dead skin is removed and replaced by healthy and new skin. It is carried out in General Anesthesia. Usually, a skin graft procedure is a successful process but it is major surgery having its risks and complications. 

It involves a full team of medical professionals like Plastic surgeons, Dermatologists, Head and neck surgeons. Two types of skin grafts are usually performed. The procedure is carried out depending on your overall health, requirements, age, any medical history. 

Split–thickness skin graft -  In this graft, only the top two layers of the skin are removed from the donor site and transplanted to a site that is to be grafted. Stitches are done to hold the skin graft in place. However, the donor site heals with wound dressing only.

Full-thickness graft – In this graft, the entire thickness of skin and tissues are removed from the donor site. Both donor and recipient sites require stitches in this graft. 

The grafts are rejected if there is an active infection or poor blood supply to the area where the graft is placed. It is not carried in people who are above the age of 60, chronic smokers, have poorly controlled diabetes, and are on blood pressure medications. 

The donor is usually the patient himself or herself. The patient's skin is used as the donor site. The inner thigh area, buttock region, back, or abdomen is the most common donor site depending on the matching of skin color and also these areas are covered by clothes usually. Or these grafts are taken from the twin of the patient. The new skin rejection is common if the graft is used from another donor.
 

The surgery is planned many weeks before. The surgeon would take into consideration your overall health, your medical history, if you are taking medications like Aspirin the dosage would be adjusted by consulting your physician if it can't be stopped. Medications like Aspirin interfere with clot formation. Your surgeon would also advise you to stop smoking, consumption of tobacco products, control your hypertension, diabetes in planning your surgery. 

The skin is removed from the donor site and placed over the transplant area with stitches. Multiple holes are punched in the graft so that less skin is harvested from the donor site. Care should be taken, fluid collection should not occur under the graft otherwise it leads to graft failure. The donor site is covered with wound dressing which heals in due course of time. 

You need to be hospitalized after grafting for few days where your vitals are monitored. In few hours graft starts developing blood vessels, the development of blood vessels is important, otherwise, there might be graft rejection. 

Post-discharge from the hospital you might need to take care of your graft side including the donor site. You would be prescribed medications like pain killers and would be advised about how to take care of the graft. The donor site heals early the recipient site. Any physical exercise or too much activity is avoided for at least two months to prevent any injury. 
 

Recovery is usually good, but in some cases like infection, poor blood supply, or due to prior habit of smoking recovery is not as required. For that second time grafting procedure is planned in such cases. 

You must always follow the instructions given to you by your healthcare provider for better healing and good recovery.