The epidermis is the outermost layer of skin, comprised primarily of keratinocytes. Split-thickness skin grafts contain the epidermis and a portion of the dermis. Considerations of proper skin graft selection should include graft take, contracture of skin graft, donor site morbidity, aesthetic match, and durability. The advantages and disadvantages of STSGs are best highlighted by comparison with FTSGs. Thus, donor sites can be used more than once after appropriate healing has taken place, which makes STSGs versatile in burn surgery and large wounds where there are limited donor sites. Because split-thickness skin graft donor sites retain portions of the dermis, including dermal appendages, the donor site can regrow new skin in 2 to 3 weeks. Split-thickness skin grafts classify according to their thickness into thin STSGs (0.15 to 0.3mm), intermediate STSGs (0.3 to 0.45mm), and thick STSGs (0.45 to 0.6mm). Most commonly, STSG autografts are taken from the lateral thigh, as well as trunk, as these sites are both aesthetically hidden, as well as easy to harvest from due to their broad surfaces. Unlike flaps, skin grafts do not have their own blood supply, so they must rely on a well-vascularized wound bed for graft in-growth. Split-thickness skin grafts are obtainable from multiple sources (autograft, homograft, allograft, or xenograft), multiple anatomical locations, and in various thicknesses. After incorporation, skin grafts provide wounds with protection from the environment, pathogens, temperature, and excessive water loss like normal skin.Ī split-thickness skin graft (STSG), by definition, refers to a graft that contains the epidermis and a portion of the dermis, which is in contrast to a full-thickness skin graft (FTSG) which consists of the epidermis and entire dermis. The rationale of skin grafts is to take skin from a donor site that will heal and transfer the skin to an area of need. Skin grafting is the transfer of cutaneous tissue from one portion of the body to another, often used to cover large wounds.
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