Split-thickness skin grafts (STSG) are grafts that include two skin layers of your body. The full epidermal skin layer and part of the dermal skin layer. Grafts that are up to four inches wide and 10-12 inches long can be removed from flat body surfaces. These surfaces are the abdomen, thigh or back. These grafts are sown or stapled into place and covered with compression dressings. The dressings are tightly wrapped with elastic bandages in order to offer firm contact. Occasionally, a doctor will leave the graft sites open to air.
Split-thickness grafts are commonly not performed on your hands and feet. These are areas of the body that are subject to abrasion or are a weight-bearing parts your body. In general, if there is too little donor skin available STSG is applied as meshed and expanded, in order to maximize graft coverage, or intact sheets. Meshing involves cutting tiny holes in the donor skin so it can be stretched to cover more surface area. The advantage of STSG includes less tissue use. That offers a higher percentage rate of graft survival and it minimizes the donor site damage. The one disadvantage, of STSG, is that it
tends to contract more than full-thickness skin grafts.
Full-thickness skin grafts (FTSG) consists of both the epidermal and complete dermal skin layers. This type of graft can offer a better cosmetic outcome then split thickenss grafts. It is also used when skin flap surgery is not available. Advantages of a thicker graft is that if offers less chance for contraction to occur, increased resistance to
trauma and less deformation both functionally and cosmetically.
Comparison Chart of Split-Thickness and Full-Thickness Skin Grafts
Split-Thickness Skin Graft (STSG)
Full Thickness Skin Graft (FTSG)
100% Epidermis & Part of the Dermis
100% Epidermis & Dermis. Also A Percentage of Fat
High Chance of Graft Survival
Lower Chance of Graft Survival
Confronting to Trauma
Poor Cosmetic Appearance. Offers Poor Color and Texture Match. This Also Does Not Prevent Contraction.
Better-Quality Cosmetic Appearance. Thicker, and Prevents Contraction or Deformation.
Temporarily or Permanently Performed After Excision of a Burn Injury, As Long As There Is Sufficient Blood Supply.
When Aesthetic Outcome Is Important (e.g., Facial Defects).
Donor Site Tissue
Abdomen, Buttock, Inner or Outer Arm, Inner Forearm and Thigh
Nearby Site That Offers Similar Color or Texture To The Skin Surrounding The Burned Area.
Poor Cosmetic Appearance, a Greater Chance of Distortion or Contraction.
A Higher Risk of Graft Failure. The Donor Site Requires Long-drawn-out Healing Time And Has A Greater Risk Of Deformation And Hypertrophic Scar Formation.