Managing a Wide Excisional Defect

If a wound is too big for stitches, a skin graft will be used to cover the wound. A piece of skin is taken from another part of the body and put over the area when the skin tissue is removed.  The skin graft may be taken from the thigh or bottom.

Skin grafts can be of either full or partial (split) thickness areas of skin.

Split skin grafts are usually used to resurface larger areas where aesthetic considerations are not essential. Split skin grafts use a partial thickness of skin to resurface areas and generally result in a contour defect. Although initially marked, the contour improves substantially over several months as local tissue growth factors modify the region.





Full thickness skin grafts are used mainly on the face. Reconstructing an excisional defect with a full thickness of grafted skin can result in an excellent repair as essentially the same tissue that is removed is replaced with donor skin of similar characteristics.

 

Diffuse area of pre-malignant melanocytic (pigment cell) change affecting the left side of the nose.

Six weeks after removal and repair with a graft of full thickness skin harvested from behind the ear.