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About the procedure Skin Grafting – Full-thickness & split thickness grafts for large defects

Our Philosophy on Skin Grafting

At AR Plastic Surgery, skin grafting is used to cover wounds that cannot be closed directly due to their size, location, or the amount of available tissue. The procedure involves taking healthy skin from one part of the body (donor site) and placing it on another area (recipient site) where skin is missing. Skin grafts help protect the wound, support healing, and provide coverage in areas where function or appearance is important.

The surgeons who operate at AR Plastic Surgery assess each wound carefully to determine whether a skin graft is the most suitable option. When the area is too large for stitches alone or lacks nearby skin for a flap, a graft may provide the coverage needed. Skin grafts are commonly used after the removal of skin cancer, trauma, burns, or following infections that have caused skin loss.

Our approach is based on the location of the wound, the required graft thickness, and the patient’s overall health. Patients are included in the planning process and given clear information about the procedure, expected healing time, and post-operative care. The goal is to choose a method that supports healing while prioritising comfort and safety.

Understanding Skin Grafting

Skin grafting is a surgical technique where skin is moved from one part of the body to another to cover a wound. The area that receives the graft is called the recipient site, and the area where the skin is taken from is known as the donor site. The graft helps protect the underlying tissues and supports the development of a stable skin surface.

This technique is most often used when the wound is too large to close directly or when healing without coverage could lead to complications. It is also used in areas that require durable coverage, such as the scalp, lower leg, or foot. Without proper skin coverage, these areas are at greater risk of infection, delayed healing, or fluid loss.

Skin grafts are commonly used following wide excision of skin cancer, especially in cases involving the scalp, lower limbs, or back. They are also used in cases of trauma, burns, or pressure injuries. At AR Plastic Surgery, grafting is considered after reviewing all other closure options and is tailored to meet each patient’s clinical needs.

Types of Skin Grafts

There are two main types of skin grafts: full-thickness grafts and split-thickness grafts. The choice depends on several factors, including the size of the wound, its location, and the expected cosmetic or functional outcome. Both graft types are widely used and have specific benefits.

  • Full-Thickness Skin Graft (FTSG): This type of graft includes both the outer layer of the skin (epidermis) and the full layer underneath (dermis). It is commonly used for smaller wounds in areas where appearance and movement are important, such as the face, hands, or ears. Full-thickness grafts often have a closer match in colour and texture to the surrounding skin, and the donor site is usually closed with stitches.
  • Split-Thickness Skin Graft (STSG): This type of graft includes the outer layer of skin (epidermis) and part of the deeper layer (dermis). It is often used for larger wounds, particularly on the scalp, limbs, or back. Split-thickness grafts are suitable for covering wide areas and have a higher chance of attaching successfully to wounds with reduced blood supply. The donor site typically heals on its own, similar to a shallow skin injury.

 
Each method has advantages and limitations. The decision is based on the type of wound, the ability of the area to support healing, and the availability of donor skin. These details are explained during the consultation so that patients are well informed before surgery.

What to Expect on the Day of the Procedure

On the day of surgery, patients are welcomed to the surgical facility and prepared by the clinical team. The graft and donor site are marked, and the surgical plan is reviewed again. Depending on the location and size of the graft, anaesthesia may be local (numbing the area) or general (patient is asleep during the procedure).

During the operation, the wound is cleaned and prepared to receive the graft. A thin layer of skin is then taken from the donor site and carefully placed over the recipient site. The graft is shaped and secured with fine sutures, adhesive strips, or dressings, depending on the technique used.

The donor site is covered with a dressing to support healing and reduce the risk of infection. Both the graft and donor areas are protected with specialised dressings chosen for the type and location of the wound. Before discharge, the surgical team confirms the patient is stable and provides written instructions for wound care, activity restrictions, and follow-up arrangements.

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Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors, including the individual’s genetics, diet and exercise. Some images may have the patient’s tattoos, jewellery or other identifiable items blurred to protect patient identities.

Aftercare and Recovery

Healing after skin grafting involves looking after both the graft and the donor site. It is important to keep the graft secure and avoid any pressure or friction during the early stages of healing. Dressings are usually kept in place for several days, and the timing for their removal depends on the area treated and how the wound is progressing.

Patients are advised to limit movement in the graft area and avoid activities that could disturb the healing skin. Elevation may be recommended if the graft is on a limb to help reduce swelling. Pain or discomfort may occur in both the graft and donor sites, but usually improves with appropriate wound care.

Follow-up appointments are important to check graft survival and monitor for complications. Once the graft has healed, scar care may be recommended, including the use of silicone sheets, moisturiser, or massage. Patients are also advised to protect the area from sun exposure as healing skin is more sensitive to sunlight.

Potential Risks

As with any surgical procedure, skin grafting involves potential risks. These risks are discussed during the consultation, and patients are provided with written information before the operation. Risks include:

  • Graft failure (partial or full loss of the graft)
  • Infection at the graft or donor site
  • Bleeding
  • Haematoma
  • Delayed wound healing
  • Changes in colour or texture of the graft
  • Sensation changes in the graft or donor area
  • Scarring at both sites
  • Reaction to anaesthesia

The team at AR Plastic Surgery provides support throughout the healing process and addresses any concerns during follow-up. Patients are encouraged to report any concerning symptoms such as increasing pain, swelling, or changes at the surgical site.

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