Grafting refers to a surgical procedure to move tissue from one site to another on the body, or from another person, without bringing its own blood supply with it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact is called a flap. In some instances a graft can be an artificially manufactured device. Examples of this are a tube to carry blood flow across a defect or from an artery to a vein for use in hemodialysis.
Types of grafting
The term grafting is most commonly applied to skin grafting, however many tissues can be grafted: skin, bone, nerves, tendons, neurons, blood vessels, fat, and cornea are tissues commonly grafted today.
Specific types include:
- Skin grafting is often used to treat skin loss due to a wound, burn, infection, or surgery. In the case of damaged skin, it is removed, and new skin is grafted in its place. Skin grafting can reduce the course of treatment and hospitalization needed, and can also improve function and appearance.
- Bone grafting is used in dental implants, as well as other instances. The bone may be autologous, typically harvested from the iliac crest of the pelvis, or banked bone.
- Vascular grafting is the use of transplanted or prosthetic blood vessels in surgical procedures.
- Ligament repair, as with anterior cruciate ligament (ACL) reconstruction or ulnar collateral ligament reconstruction (typically with baseball pitchers).
Reasons for failure
- Hematoma (a collection of blood) development when the graft is placed over an active bleed
- Seroma (a collection of fluid) development
- Shear force disrupting growth of new blood supply
- Inappropriate bed for new blood supply to grow from, such as cartilage, tendons, or bone