Understanding skin grafts
A skin graft moves skin from a donor site on your body to cover a wound elsewhere. It is used when direct closure is not suitable and the wound can support a graft. The graft develops a blood supply from the tissue beneath it.
Split-thickness graft
The outer skin layer and part of the deeper layer are taken, often from the thigh. The donor site heals without being stitched closed, usually over the following weeks.
Full-thickness graft
The full thickness of skin is taken from an area with enough spare skin, such as behind the ear or near the collarbone. The donor site is usually stitched closed.
Your surgeon chooses the type based on the size and location of the wound, the blood supply and the likely result.
Before your operation
Bring a current list of medicines, vitamins and supplements, and tell us about allergies to medicines, latex, antiseptics or dressings. Let the team know about diabetes, circulation problems, previous healing difficulties or a tendency to develop thick scars.
Do not stop blood thinners or change prescribed medicines without advice from your treating team. This includes prescribed aspirin. Ask about any medicine instructions before your appointment.
For a procedure under local anaesthetic alone, fasting is usually not needed unless you have been told otherwise. If sedation or general anaesthetic is planned, follow the fasting and medicine instructions provided by your hospital or anaesthetic team. Call if these are unclear.
- Bring your Medicare card, relevant referral or test results, and comfortable clothing that gives access to the treatment area.
- Discuss transport home. Arrange a responsible adult after sedation or general anaesthetic. Wound location, pain and movement can affect driving even after local anaesthetic.
- Smoking can slow healing. Ask your GP or the clinic for help stopping before surgery and during recovery.
- Ask about the benefits, risks, alternatives and likely scar before giving consent. You can ask for more time or further explanation.
What happens during surgery
The wound is prepared, the graft is taken from the donor site and shaped to fit. Stitches or staples secure it, and a dressing holds it against the wound. This may be a bolster or tie-over dressing.
Close contact with the wound bed is important while the graft develops new blood vessel connections. Movement or a collection of blood or fluid underneath can interfere with this. You will leave with separate instructions for the graft and donor site.
Protecting your graft
- Do not lift, press, rub or remove the graft dressing unless the team tells you to.
- Keep it dry and do not shower directly onto the graft until cleared.
- Rest and avoid movements that could shift or stretch the graft.
- Elevate the area as instructed, particularly for a lower-leg graft.
- Attend the first dressing review; do not remove the dressing to check the graft yourself.
If the dressing becomes wet, loose, soaked or painful, call the clinic for advice. The home dressing routine for an ordinary wound is not a substitute for your graft plan.
Looking after the donor site
The donor site is a second wound with its own dressing and healing needs. A split-thickness donor site can feel raw or tender and may be more uncomfortable than the graft in the first week. A full-thickness donor site usually has stitches.
Leave its dressing in place for the time advised. Whether it can get wet depends on the dressing used. The nurse will check both sites at your appointments and tell you when stitches or dressings can be removed.
Recovery, risks and follow-up
The first few days are particularly important as the graft begins to establish a blood supply. The team checks how much has “taken” at the first reviews. Healing continues over the following weeks; the timing varies with the wound and your health.
Possible problems include partial or complete graft loss, infection, blood or fluid beneath the graft, slow donor-site healing, and differences in colour or texture. A small area that does not take may heal with dressings; a larger area may require further treatment.
Use pain relief only as advised. Ask before returning to exercise, work or driving. Avoid swimming until both wounds are healed and the team has cleared you.
All skin surgery leaves a scar. The early pink, firm or raised appearance can change over many months; scars may continue to mature for 12–18 months. Wound location, skin type, healing and the procedure all affect the final result.
Only start scar massage or silicone products once the wound is fully closed and your clinician says it is ready. Protect healed skin from the sun and let us know if a scar becomes increasingly raised, tight or uncomfortable.
Read about scars and ongoing skin checks →
A clinician will call you if your results require urgent action. Otherwise, your results will be discussed with you at your follow-up appointment.
Confirm your review appointment before leaving. If it has not been arranged, or your results are taking longer than expected, call the clinic. No contact does not mean a result is clear.
When to seek help
- Increasing or spreading redness, warmth or swelling.
- Pain that is getting worse rather than settling, pus, a new unpleasant smell, fever or feeling unwell.
- A wound that opens, a rapidly growing swelling, or a dressing that is repeatedly soaked.
- An unexpected change in the colour or appearance of a graft, flap or BTM wound.
Call 07 7520 8580 promptly. If the clinic is closed and the problem is urgent, seek an urgent medical assessment. Do not wait for a routine review.
For bleeding, apply firm, continuous pressure with a clean dressing. If bleeding persists despite pressure, seek urgent care. For severe bleeding, collapse or another medical emergency, call 000.