Within days, patients are in the operating room for more removal of dead skin, replacing it with a graft from the patient or, if there's not enough unburned surface, skin from a skin bank or an artificial skin that enables the inner dermis to regrow under a layer of rubber that will eventually be removed. "Typically we take ten-thousandths-of-an-inch-thick outer layer of healthy skin, and that process creates a second-degree burn," Yurt said. "What I usually tell patients is they'll have more pain after than before."
The donor site can take 14 days to heal, he said. The grafted area is immobilized for three to five days. Once it is healed, an intense period of rehabilitation starts to promote flexibility in the grafted area.
Sometimes skin from the donor site is meshed; a machine doubles or triples its original size by cutting holes in it, Yurt said. But the skin that results has an unsightly, diamond-shaped pattern and is usually not used for grafts on the face or hands, he said.
Patients are released from the hospital to a rehabilitation center and then home, with four to five physical therapy sessions a week for about a year. Additional surgeries, including plastic surgeries to improve the look of earlier grafts, also may be offered.