Split Thickness Wound Care

Wound Care Instructions for Split Thickness Skin Graft Wound

Materials

Hydrogen peroxide, cotton applicators or Q-tips, paper tape, nonstick dressing pads (example — Telfa), and petroleum jelly (example — Vaseline or Aquaphor)

Appearance

GRAFT: Grafts depend on the blood supply from the base and edges of the wound in order to heal or "take." To help the new skin placed over the wound "take," a cotton dressing is sewn in place for the first week. This dressing is referred to as a bolster and must remain in place until removed by our staff at your suture removal appointment in approximately 7 days. The bolster may become discolored and have dried blood around the edges. The skin edges around the bolster may appear swollen and red, this is normal.

DONOR SITE: The area where skin has been taken to repair your surgical wound is called the "donor site." A plastic-like bandage (example — tegaderm) is directly covering the wound. A pressure dressing is applied over the first bandage with an ace-type bandage.

WOUND CARE: Immediately following your surgery a "pressure" dressing will be placed on top of your graft and your donor site. These will remain in place for 24 hours. If they come loose re-tape them. After 24 hours remove them and begin wound care 2 times per day as follows:

GRAFT: Gently cleanse around the bolster with a Q-tip dipped in diluted peroxide (½ peroxide and ½ tap water). Use as many Q-tips as necessary to remove any dried blood or scabs around the edges of the bolster. Next apply petroleum jelly directly on top of the bolster and cover with a non-stick dressing. You may leave the bolster uncovered if you will be home. AVOID WETTING OR MOVING THE BOLSTER!

DONOR SITE: The pressure dressing may be removed after 24 hours, but leave the plastic bandage in place. Pinkish-red fluid will collect under the dressing and that is normal. If the dressing leaks, cover it lightly with tape and gauze. This area usually requires no special care. You may bathe, after wrapping the area in plastic wrap, such as Saran wrap. IF the plastic bandage comes off, cleanse the area twice daily w/ diluted hydrogen peroxide. Dry with clean Q-tips. Apply petroleum jelly and cover with a nonstick Telfa dressing, tape in place.

If you notice increasing pain, swelling, redness, heat or pus-like drainage from the site, these are signs of infection. Please call our office immediately.

BLEEDING: Careful attention has been given to your wound to prevent bleeding. The pressure dressing will help prevent bleeding. You may notice a small amount of blood on the edges of the dressing the first day and this is normal. If the bleeding seems persistent and soils the dressing, apply firm, steady pressure over the dressing with gauze for 20 minutes. If bleeding continues, repeat pressure for 20 minutes. If bleeding persists, call the doctor or go to the nearest ER while continuing to hold pressure on the wound.

PAIN: Post-operative pain is usually minimal. Regular or Extra strength Tylenol, 2 tablets every 4 hours, usually relieves any pain you may have. To minimize pain, swelling and bruising, apply an ice pack or frozen bag of vegetables over the dressing during the first 24 hours every 2 to 3 hours for 20 minutes. After the first 24 hours, warm, moist compresses a few times a day may help.

Elevating the surgical site during the first 48 hours will reduce swelling, bruising and pain. If the surgical site is on the face, neck or head sleeping in a recliner or propped on pillows is helpful.

DO NOT TAKE ANY MEDICATION CONTAINING ASPIRIN, IBUPROFEN OR SIMILAR NON-STEROIDAL PAIN MEDICATIONS, BLOOD THINNERS OR DRINK ANY ALCOHOL 3 DAYS AFTER SURGERY (unless otherwise instructed). Continue to take all other prescribed medications.

NOTES:

• Never place a used Q-tip back into the hydrogen peroxide
• Make sure to wash your hands with soap and water, and if you are using scissors to trim your bandage clean them with alcohol before each use.
• Change the dressing twice daily for 2 weeks, then once daily until the wound is completely healed, unless otherwise instructed.
• If the wound is near the eye, saline eyewash (ex-Dacriose solution) may be used on a Q-tip to clean the corners of the eye.
• Do not wet the pressure dressing during the first 24 hours. After that you may shower as usual. The dressing will act as protection during the shower, but do not let the stream of the shower directly hit the wound. Apply a new dressing after each shower.
• You may have a low grade fever (99 to 100 degrees F) — you may take Tylenol if necessary.
• Clear drainage from the wound is normal. This will stop after a few days.
• It is a myth that wounds heal better with a scab or left open to the air. If a scab begins to form, soak the wound with diluted hydrogen peroxide and gauze for 15 minutes and gently rub it away with a Q-tip. Repeat as needed.

IF YOU HAVE ANY QUESTIONS, PLEASE DO NOT HESITATE TO CALL OUR OFFICE AT (806) 354-4900 MONDAY-FRIDAY, ON WEEKENDS OR EVENINGS YOU MAY CALL DR. PROFFER ON HER CELL PHONE (806) 683-9776