Skin Grafting


Sarah Lewis, PharmD

What is skin grafting?

Skin grafting is the surgical transplantation of skin and its underlying tissues from one area to another. Doctors use skin grafting to restore the barrier function and cosmetic appearance of the skin after irreparable damage. Skin grafting involves removing damaged or dead skin tissue and replacing it with new, healthy skin. 

Skin grafting is major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having skin grafting.

Types of skin grafting

The types of skin grafting include:

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  • Allograft is skin from a human donor, usually a cadaver. This graft is temporary until your own skin grows back or until the area is ready for an autograft.

  • Autograft is your own skin from another body area, usually an area that is covered by clothing, such as the inner thigh. This type of graft is permanent.

  • Skin substitute is a synthetic or semi-synthetic material that can be a temporary or permanent skin replacement. Cultured skin grown in a lab from a small piece of your own skin falls under this category.

  • Xenograft is skin from an animal donor. This is a temporary graft until your own skin grows back or until the area is ready for an autograft.

Other procedures that may be performed 

Your doctor may perform additional reconstructive procedures in addition to skin grafting. Ask your doctor about other procedures that may be necessary in addition to skin grafting.

Why is skin grafting performed?

Your doctor may recommend skin grafting to treat certain diseases, disorders and conditions of the skin and underlying tissues. Your doctor may only consider skin grafting for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on skin grafting.

You doctor may recommend skin grafting to treat:

  • Cancer including skin cancer and post-mastectomy reconstruction for breast cancer

  • Cosmetic defects including scars and other skin disfigurements

  • Infections including infections that have caused tissue death and skin loss

  • Non-healing ulcers including diabetic ulcers, pressure ulcers, and venous ulcers

  • Open wounds including burns and trauma wounds, especially large wounds that need help healing

  • Surgical wounds including incisions that are difficult for the surgeon to close

Who performs skin grafting?

The following specialists perform skin grafting:

  • Plastic surgeons specialize in aesthetic and reconstructive surgery.

  • General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions, including surgery of the breast, abdomen, and skin and soft tissue.

  • Dermatologists specialize in the medical and surgical care of the skin, hair and nails.

  • Facial plastic and reconstructive surgeons specialize in plastic and reconstructive surgery of the face. They initially train as plastic surgeons or otolaryngologists (ear, nose and throat doctors/surgeons).

  • Head and neck plastic surgeons specialize in correcting physical defects within the head and neck that can affect a person's appearance and ability to function.

How is skin grafting performed?

Your skin grafting will be performed in a hospital, surgeon's office, or outpatient surgery setting. Your team will surgically remove (debride) the damaged skin and tissues in preparation for skin grafting.

Split-thickness skin grafts: Most skin grafting procedures are split-thickness skin grafts. Your surgeon will remove only the top two layers of skin from the donor site and transplant them to the new site. Your surgeon will use an instrument that peels off the layers. Staples, stitches, or a special padded dressing will hold the skin graft in place while it heals. The donor site usually heals quickly with only a wound dressing.

Full-thickness skin grafts: Full-thickness skin grafts use the entire thickness of the skin and underlying tissues. Your surgeon will cut out the full thickness of donor skin and transplant it to the new site. Staples or stitches hold the skin graft in place while it heals. The donor site also requires staples or stitches to close it.

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference.  Learn about the different procedures and ask why your surgeon will use a particular type for you.

Types of anesthesia that may be used

Your surgeon will perform a skin graft using either general anesthesia or regional anesthesia.