Skin grafting is a surgical procedure that involves removing skin from one area of the body and moving it, or transplanting it, to a different area of the body. This surgery may be done if a part of your body has lost its protective covering of skin due to burns, injury, or illness.
A split-thickness graft involves removing the top layer of the skin — the epidermis — as well as a portion of the deeper layer of the skin, called the dermis. These layers are taken from the donor site, which is the area where the healthy skin is located. Split-thickness skin grafts are usually harvested from the front or outer thigh, abdomen, buttocks, or back.
Split-thickness grafts are used to cover large areas. These grafts tend to be fragile and typically have a shiny or smooth appearance. They may also appear paler than the adjoining skin. Split-thickness grafts don’t grow as readily as ungrafted skin, so children who get them may need additional grafts as they grow older.
A full-thickness graft involves removing all of the epidermis and dermis from the donor site. These are usually taken from the abdomen, groin, forearm, or area above the clavicle (collarbone). They tend to be smaller pieces of skin, as the donor site from where it’s harvested is usually pulled together and closed in a straight-line incision with stitches or staples.
Full-thickness grafts are generally used for small wounds on highly visible parts of the body, such as the face. Unlike split-thickness grafts, full-thickness grafts blend in well with the skin around them and tend to have a better cosmetic outcome.
The graft should start developing blood vessels and connecting to the skin around it within 36 hours. If these blood vessels don’t begin to form shortly after the surgery, it could be a sign that your body is rejecting the graft.
This may happen for several reasons including infection, fluid or blood collecting under the graft, or too much movement of the graft on the wound. This may also happen if you smoke or have poor blood flow to the area being grafted. You may need another surgery and a new graft if the first graft doesn’t take.
The donor site will heal within one to two weeks, but the graft site will take a bit longer to heal. For at least three to four weeks after the surgery, you’ll need to avoid doing any activities that could stretch or injure the graft site. A follow-up appointment will be needed to determine when you can resume your normal activities.