Skin Grafts and Flaps

Key points

• • When a wound is too large to stitch closed, skin can be moved from elsewhere to cover it, as a graft or a flap.
• • A skin graft is a sheet of skin taken free from a donor site, with no blood supply of its own, that must take up a new supply from the wound bed.
• • A split-thickness graft takes the upper layers and covers a large area, while a full-thickness graft gives better quality but covers less.
• • A graft needs a clean, well-supplied bed to survive, and it fails if there is infection, movement or bleeding beneath it.
• • A flap carries its own blood supply with it, so it can cover areas such as bare bone or tendon where a graft would not take.