Full-Thickness Skin Grafts

Excerpt

A skin graft is a cutaneous free tissue transfer that is separated from a donor site and transplanted to a recipient site. Skin grafts are chosen when healing by second intention, primary closure, or flap repair are deemed unsuitable. Full-thickness skin grafts (FTSGs) consist of complete epidermis and dermis, whereas partial-thickness skin grafts (PTSG) include the entire epidermis and only partial dermis. FTSGs are relatively simple to harvest and to secure within the recipient site, and they are particularly well suited to defects on the nasal tip, dorsum, ala, and sidewall as well as on the eyelids and the ears. Optimal donor skin should closely match color, thickness, the degree of actinic damage, and texture of the skin surrounding the defect. Advantages of FTSGs are that they do not alter the architecture of the recipient site and are relatively easy for both the patient and the surgeon. The main complication of this procedure is that partial or full-thickness graft failure may occur. FTSGs have advantages over PTSGs, and these include less contraction on healing, generally better aesthetic result, and thicker skin that is more resistant trauma. However, FTSGs also have a greater risk of graft failure, are more limited in the size of defects and choice of the donor site, and the donor defect must be closed or proceed through a lengthier period of second intention healing.