A partial thickness donor site must heal by re-epithelialization which can be painful and take an extensive length of time.
Two layers of skin created from animal sources has been found to be useful in venous leg ulcers.
By source: Allografts, xenografts, and prosthetic grafts are usually used as temporary skin substitutes, that is a wound dressing for preventing infection and fluid loss.
[citation needed] In order to remove the thin and well preserved skin slices and strips from the donor, surgeons use a special surgical instrument called a dermatome.
The dermis left behind at the donor site contains hair follicles and sebaceous glands, both of which contain epidermal cells which gradually proliferate out to form a new layer of epidermis.
The healing process for skin grafts typically occurs in three stages: plasmatic imbibition, capillary inosculation, and neovascularization.
Between 2–3 days, new blood vessels begin growing from the recipient area into the transplanted skin in a process called capillary inosculation.
Between 4–7 days, neovascularization occurs in which new blood vessels form between the graft and the recipient tissues.
To prevent the accumulation of fluid under the graft which can prevent its attachment and revascularization, the graft is frequently meshed by making lengthwise rows of short, interrupted cuts, each a few millimeters long, with each row offset by half a cut length like bricks in a wall.
A vacuum unit then creates negative pressure, sealing the edges of the wound to the foam, and drawing out excess blood and fluids.
NPWT can also be used between debridement and graft operations to assist an infected wound in remaining clean for a period of time before new skin is applied.
[12][13][14][15] Z-plasty is of paramount importance to the plastic surgeon and a frequently used method in both single multiple forms.
Graft recipients wear compression garments for several months and are at risk for depression and anxiety consequent to long-term pain and loss of function.
[18] Around 500 years later, members of the Hindu Kamma caste are described as performing skin grafts which included the usage of subcutaneous fat.
Other animals that can be used include dogs, rabbits, frogs, and cats, with the greatest success achieved with porcine skin.
[12][13] Other skin substitutes include Allograft, Biobrane, TransCyte, Integra, AlloDerm, Cultured epithelial autografts (CEA).