What is a Full Thickness Skin Graft?
What is a full thickness skin graft?
A full thickness skin graft (FTSG) is another type of skin grafting procedure, distinct from a split thickness skin graft (STSG).
Why “Full Thickness?”
A full thickness skin graft involves removing an area of the entire skin thickness (epidermis and full depth of dermis) from a donor site and transplanting it to the recipient site.
How are they used compared to a split thickness skin graft?
- FTSGs are typically used for smaller, more discrete areas compared to STSGs.
- As the heal, they shrink much less than split skin grafts. So they are commonly used on the face, head and neck and hands, to prevent or reduce a contracture which would compromise function.
- In visible areas where the aesthetic appearance is better than a split skin graft.
- A FTSG is more durable than a split skin graft, for instance on the palm or sole.
- A FTSG is more demanding in terms of blood supply at the recipient site, with a higher risk of graft failure.
- FTSGs often provide a better colour and texture match to the recipient area than a STSG, and may better retain skin characteristics (e.g., hair growth).
How are they done?
The area of skin taken is usually limited by being able to stitch the margins of the donor site back together. Donor sites include the skin behind the ear, the lower neck crease line and the upper/inner arm. Grafts are harvested by using a normal scalpel blade to cut around a carefully pre-marked area, before shaving back the included skin at the level between the dermis and fat. They are secured into the recipient wound by suturing around the margin, and “quilting” sutures through the base.
Full thickness skin grafts are typically chosen for smaller, more visible areas where function and cosmetic outcome is crucial. while split thickness grafts are often used for larger wounds where rapid healing is the priority. The choice between the two depends on factors such as the wound size, location, available donor sites, and the patient's overall condition.