What to Expect From a Skin Graft

A skin graft is a surgical procedure in which an area of skin that has been damaged to the point of being unable to repair itself is replaced with healthy skin. The healthy skin is usually removed from one area of a person's body and transplanted to the damaged area, though skin from a donor can be used in some cases.

Skin grafts are used to treat burns and ulcers, as well as in reconstructive surgeries. In general, the outcome for this type of surgery is excellent.

Surgeons performing surgery in operating room
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Reasons for a Skin Graft

Skin grafting may be used for skin that has been damaged by:

Who Is Not a Good Candidate

Skin grafts carry more risks for young infants, people who are over age 60, smokers, people who have a chronic illness, and people who take certain medications, such as high blood pressure drugs, muscle relaxants, and insulin.

If you have uncontrolled skin cancer or an active infection, you cannot receive a skin graft.

A skin graft is not appropriate for deep wounds that have penetrated into the tissue beneath the skin or have caused bone exposure. These normally require the use of skin flaps or muscle flaps, where the transplanted tissue has its own blood supply.

Types of Skin Grafts

There are three main types of skin grafts:

  • A split-thickness graft is the most commonly used type of skin graft. It removes only the epidermis (the top layer of skin) and part of the dermis (the middle layer of skin). This allows the source site to heal more quickly. This type of graft is more fragile than the others and may leave the donor site with abnormal (lighter) pigmentation.
  • A full-thickness graft removes the epidermis and the full dermis in their entirety. Cosmetically, the outcome is usually better, which is why full-thickness grafts are usually recommended for the face. The use of full-thickness grafts is somewhat limited. They can only be placed on areas of the body that have significant blood vessels to ensure the graft’s survival.
  • A composite graft can entail removal of skin, fat, muscle, and cartilage. These grafts are typically used in areas that require three-dimensional reconstruction, such as the nose.

Face grafts are usually small, full-thickness, or composite grafts. Donor sites include skin in front of or behind the ear for full-thickness grafts, or the ear itself for composite grafts.

Types of Donors

The most successful skin grafts are typically those that use the patient’s own skin. Known as autografts, skin is harvested (removed) from another area of person's body. Surgeons make an effort to choose a donor site that is normally covered by clothes.

They will also try to match skin color and texture as closely as possible between the donor and recipient sites. The inner thigh and buttocks are the most common donor sites. The upper arm, forearm, back, and abdomen may be used as well.

Skin grafts can also be successful when harvested from an identical twin of the patient.

An allograft is a procedure when a separate donor is not an identical twin. There is a higher chance of the body rejecting the new skin from an allograft because the body sees it as foreign tissue, and the immune system attacks it.

Alternative Donor Sources

Alternative graft sources are meant only for temporary use before a graft or until the patient’s own skin grows back.

Such sources include:

  • Allograft, in which skin from a human cadaver is donated for medical use. Cadaver skin is put over the excised wound and stapled in place.
  • Xenograft, in which skin is taken from an animal, usually a pig. This has become an option because of the limited availability of human skin tissue.
  • Synthetic skin, made in a laboratory, may be used in specific circumstances, such as for superficial burns. Currently, its use is limited and more research needs to be done before it becomes a true option.

Before Surgery

Your skin graft surgery will be scheduled several weeks in advance. Your healthcare provider may want you to stop certain medications—such as aspirin and warfarin—that can interfere with the blood's ability to form clots; always tell your healthcare provider ahead of time about any prescription or over-the-counter medications you’re taking.

Discuss any smoking or other use of tobacco products with your healthcare provider. These will affect your skin's ability to heal after a graft.

Surgical Process

Here is a step-by-step description of how skin graft surgery is performed:

  1. The wound is prepped for surgery and a pattern of the area to be covered is traced to help determine the amount of skin removal from the donor site.
  2. Anesthesia is administered. Depending on the size, severity, and location of the wound, as well as the type of graft, the procedure may require local anesthesia, regional anesthesia, IV sedation, general anesthesia, or a combination of these.
  3. The donor skin is removed with a scalpel or with the help of a special machine called a dermatome. The graft may also be “meshed,” a process wherein multiple controlled incisions are placed in the graft. This technique allows fluid to leak out from the underlying tissue and the donor skin to spread out over a much larger area.
  4. The donor site is then closed. With a full-thickness or composite graft, this is done with sutures. With a split-thickness graft, a surgical closure is not needed at the donor site. Instead, a dressing is placed after the skin is removed.
  5. The graft is placed on the recipient site. Once in place, the graft is fastened to the surrounding tissues with sutures or staples.
  6. A pressure bandage is applied over the graft recipient site. A special vacuum apparatus called a wound VAC may be placed over the area for the first three to five days to control drainage and increase the graft’s chances of survival.


Risks and potential complications of skin grafts include:

  • Bleeding
  • Hematoma
  • Infection
  • Rejection/loss/death of the graft
  • Unsatisfactory aesthetic results, such as scarring, skin texture irregularities, discoloration, or hair loss
  • Loss or reduction in skin sensation
  • Increased sensitivity
  • Chronic pain (rarely)
  • Anesthesia-related risks

After Surgery

Within the first 36 hours after surgery, the graft should begin to grow new blood vessels which then connect to the recipient's skin that surrounds it.

Recovery after receiving a skin graft will vary depending on the complexity of the procedure. A split-thickness graft may heal after only a few days. Full-thickness grafts take longer to heal and may require a one- to two-week hospital stay.

The donor site typically takes between a few days to a week to heal. Your healthcare provider will likely give you a prescription for painkillers to help minimize pain.

With an allogenic transplant, you will be given immunosuppressive drugs to prevent your body's rejection of the donated skin. Because these drugs suppress the immune system, they increase vulnerability to infections and may have toxic effects on other organs, such as the kidneys.

After you are discharged from the hospital, you will wear a dressing for one to two weeks. Ask your provider how you should care for the dressing and protect it from getting wet. You will also need to protect the graft from trauma for three to four weeks. This includes avoiding and bumps to the areas or doing any exercise that might injure or stretch the graft.

In some cases, your surgeon may recommend physical therapy if your graft interferes with your ability to move one of your limbs or joints fully.


The prognosis for most skin grafts is very good. The reason for your surgery can impact your prognosis.

In some cases, infection, fluid, blood collecting under the graft, or too much movement of the graft on the wound can interfere with the graft healing properly. Healing can also be impaired if you smoke or have poor blood flow to the area being grafted.

You may need another surgery and a new graft if the first graft doesn’t heal properly to replace your damaged skin.

Support and Coping

How you feel after having a skin graft will most likely depend on the reason for and location of the graft and its appearance after it's healed. Your healthcare provider can provide resources if you want to seek support among a community of people who have undergone grafts for similar reasons, such as burns, skin cancer, or reconstructive or plastic surgery.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • Ahmad, S, Teng L, et al. Biologic and synthetic skin substitutes: An overview. Indian J Plast Surg. 2010;43(Suppl):S23-S28. doi:10.4103/0970-0358.70712

  • Prohaska J, Cook C. Skin Grafting. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

  • Ruka, S, Kazuo, K. Skin Graft. Plast Surg Int. 2012:563493. doi:10.1155/2012/563493