Skin Graft Harvesting and Donor Site Selection

Acute and chronic wounds are characterized by breakdown of the integrity of the soft tissue envelope surrounding any portion of the body. Flaps and grafts are the two main surgical procedures utilized to repair soft tissue loss. A simple skin graft applied as a thin layer harvested with a dermatome, a scalpel or a special knife may provide a durable coverage. A free skin graft is a piece of skin that has been completely separated from its local blood supply and transferred to a wound at another site, where it must establish new vascular connections through the recipient bed to survive. Skin grafts usually are the first consideration when primary wound closure cannot be achieved. This is true especially for deep burns of wide body areas.(Rudolph R, Ballantyne DL. Skin grafts. In: McCarthy JG, ed. Plastic Surgery. Philadelphia: Saunders; 1990:221–274) A skin graft would be contraindicated, if inosculation from the recipient bed is unreliable with repeated motion or trauma to the area, or in wound infection (Paletta CE, Pokorny JJ, Rumbolo P. Skin grafts. In: McCarthy JG, ed. Plastic Surgery. Philadelphia: Saunders Elsevier; 2006:293–316.)