grafting

grafting [graft´ing]

transplantation. The term grafting is preferred in the case of skin grafting and of synthetic grafts such as arteriovenous grafts.

skin grafting implantation of patches of healthy skin on a denuded area to provide epithelial covering; the skin may come from another area with healthy skin from the patient's own body or from the body of a skin donor. The most important function of skin grafting is to promote healing of large surfaces that have been burned or wounded, or that have become ulcerous or cancerous. If burns or other injuries are extensive, grafting can prevent extensive scarring with unsightly tissue that cannot perform all the necessary functions of normal skin. Skin contractures can thus be avoided.

The skin to be grafted is cut usually from the chest, thigh, buttock, abdomen, lower part of the neck, or behind the ear. It may be removed in very thin strips or as a thin layer of superficial skin, and it must be placed in its new location without delay. If delay is unavoidable, it is placed in a saline solution or refrigerated. In this kind of free graft, the skin is cut entirely away from the body before transplantation and then is sewed into place; a pressure dressing is applied or a tissue glue is used. Afterwards the skin must depend for its nourishment on the surrounding tissue in the new location.

If a large thick area of skin containing much underlying tissue is to be moved, the traditional method has been to do this by means of a pedicle flap. For example, an injured hand that needs skin grafting would be strapped against the abdominal wall to receive a pedicle graft of skin from the abdomen. However, the introduction of microsurgery has eliminated much of the need for this kind of graft.

A skin graft can sometimes be made by the simple procedure of cutting a piece of healthy skin from one part of the body, such as the back or the thigh, and stitching it to the injured area. Small arteries from the tissues surrounding the injured area then grow into the graft, nourish it with blood and promote normal growth. If the area to be covered is large, a number of separate patches may be stitched to it, forming islands of skin that will enlarge with healing until the entire area is covered. This is called “postage stamp” or pinch grafting.

With the advent of microsurgery, much of the inconvenience and lengthy waiting necessary for successful grafting of skin flaps have been eliminated. It is now possible for a surgeon to perform what are called free-tissue transfers. The skin flap is removed from the donor site and transferred directly to the distant recipient site where circulation to the free flap is reestablished by microvascular anastomoses.

There are many different types of skin grafts, including dermal or dermic, epidermic, full-thickness, split-thickness, thick-split, inlay, mesh, pinch, sieve, and Ollier-Thiersch grafts. See also flap.

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grafting,

n 1. transplantation of tissue from one side to another, as in skin grafting with burns.
2. in homeopathy, a controversial method of augmenting the remainder of an existing remedy with a different dosage form or other nonmedicated tablets.

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grafting

1. the implanting or transplanting of skin or other tissue from another part of the body or from another animal to serve as replacement for damaged or missing tissue. The purpose may be to encourage healing, to improve function, to act as a safeguard against infection, to improve appearance, or to replace a diseased body organ. See also transplantation.

2. of orphan calves. See fostering.