Skin graft aftercare guide: following the plan after surgery.

Whose instructions come first

The first rule in any skin graft aftercare guide is that the clinician who performed the procedure sets the plan. The surgical team knows what kind of graft was placed, how it was secured and what the area needs. Their written instructions come before general advice, including this page.

A home health nurse, facility staff, a wound care clinician or a family member may help along the way. Each should work from the same instructions. If two sets of directions conflict, ask the surgical team which one applies before anything is changed.

Two sites to look after

Many skin grafts leave two healing areas. The graft site is the wound that received the new skin. The donor site is where the skin was taken from.

The two sites heal differently and usually have different dressings and instructions. A new graft is fragile. It has to stay still and in close contact with the wound underneath while a new blood supply grows into it. The donor site is often compared to a deep scrape. Our page on skin graft aftercare explains how each area heals.

What to confirm before you go home

Ask these before discharge, with a family member present if you can, and write down the answers.

• Who do I call with questions, during the day and after hours?
• When is my first follow-up, and who will check the graft site and the donor site?
• Who changes each dressing, how often, and which dressings should be left alone?
• What are my limits on walking, standing, lifting, bending and driving?
• Does the area need to be raised or kept still?
• When may I shower, and how do I keep the dressings dry until then?

Ask for the instructions in writing, and give a copy to home health or facility nurses at their first visit.

Protecting the graft day to day

Rubbing, bumping, stretching or sliding the skin near a new graft can shift it before it has attached. Your instructions may limit movement of a nearby joint or ask you to keep an arm or leg raised. Follow those limits even when you feel well.

These habits usually fit within a surgical team’s plan:

• Wear loose clothing that does not drag across the dressings.
• Move slowly getting in and out of a bed, chair or car.
• Keep dressings dry unless told otherwise. See showering and bathing with a wound for questions to ask.
• Avoid tobacco, and tell your clinician if that is hard.
• Eat regular meals with enough protein, within any dietary limits you have. See eating for wound healing.

Ask the surgical team before you change a dressing schedule, apply a cream or ointment, or return to a restricted activity.

Changes to report to the surgical team

Call the surgical team, or the after-hours number you were given, if you notice:

• A dressing that has loosened, slipped, come off or become wet
• Graft edges that appear to be lifting, or fluid collecting under the graft
• Pain that is getting worse instead of easing
• Drainage that increases, turns cloudy or develops an odor
• Redness, warmth or swelling that spreads from either site
• Areas of the graft that turn dark, black or very pale
• Bleeding that soaks through a dressing
• Fever or chills

Several of these are general signs of wound infection.

Call 911 for bleeding that will not stop with firm pressure, trouble breathing, chest pain, confusion or fainting.

Keeping everyone on the same plan

Graft recovery often crosses several settings: the hospital or surgery center, home, and sometimes a rehabilitation or skilled nursing facility.

Instructions can be lost at each move, so carry the written copy with you and tell every new nurse or caregiver that you have a graft and a donor site. If the surgical team changes the plan, ask for the update in writing and replace the old copy.

Gateway coordinates skin graft and donor site follow-up with partner clinicians in Greater St. Louis and the Metro East. We gather the surgical instructions, arrange visits where they are available and keep the surgical team informed. To ask about follow-up, call 314-325-0126 or send a request for care.

After the graft has healed

Healed graft and donor skin is often drier, more sensitive to sun and a different color or texture from the skin around it. Ask the surgical team when to begin moisturizing, how to protect the area from the sun and whether scar care is part of your plan. Our guide to scars and skin after a wound heals covers long-term skin care.

Common questions

Related pages

• Skin graft aftercare
• Skin graft and donor site follow-up
• Scars and skin after a wound heals
• Signs of wound infection
• Showering and bathing with a wound
• Talking about wound pain
• Leg ulcer compression questions
• When to call a wound care specialist