Split and Full Thickness Grafts

I thought I'd explain the differences between split thickness grafts and full thickness grafts since I speak of them often.

A split thickness graft is where they shave off, like peeling a potato, a layer of your skin, this becoming what is called "the donor site." Split thickness grafts hurt incredibly bad let me tell you. Split thickness grafts are more often used because there is lower risk that that the body will reject the graft.

Now there are two different kinds of split thickness grafts. There is one where they shave the skin off and run it through a machine that punches holes in the skin called a meshed graft and giving a "designed" look on the skin where it was grafted. Those diamond-like shapes heal into the skin and stay that way. And then there are split thickness grafts that are not meshed.

Full thickness grafts are where they actually cut away all the layers of your skin and are then stithed back up. In a split thickness, there is no stitching required. However, a full thickness runs much greater risk of the graft being accepted by the body. Full thickness grafts also leave smaller scars on the donor site.

In order to remove the thin skin slices and stripes from the donor, surgeons use a special surgical instrument called a dermatome. This usually produces a split-thickness skin graft, which contains the epidermis. The dermis left behind at the donor site contains the hair follicles and glands that gradually regrow to form a new layer of epidermis. The donor site may be extremely painful and vulnerable to infection.

The graft is carefully spread on the bare area to be covered. It is held in place by a few small stitches or staples. The graft is initially nourished by a process called plasmatic imhibition in which the graft literally "drinks plasma". New blood vessels begin growing from the recipient area into the transplanted skin within 36 hours in a process called capillary inosculation. To prevent the accumulation of fluid under the graft which can prevent its attachment and revascularization, the graft is frequently meshed by making lengthwise rows of short, interrupted cuts, each a few millimeters long, with each row offset by half a cut length like bricks in a wall. In addition to allowing for drainage, this allows the graft to both stretch and cover a larger area as well as to more closely approximate the contours of the recipient area.

Most of my body is split thickness, meshed grafts so I have that diamond look all over my body. I have only had three full thickness grafts done and that's very few compared to all the split thickness. So if you spend some time with me I will have to show you what my skin looks like now. It is scarred with diamonds. Though my reconstructive surgeon wants to regraft them using either full thickness or split thickness non meshed so that I don't have those scars on my body. We'll see what happens with that, mainly because of my insurance allowing it to be redone.