Skin Grafts — SCE Dermatology MCQ

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EasyDermatological SurgerySkin GraftsSCE Dermatology

A 60-year-old man with a chronic wound has been referred for skin grafting. His surgeon explains the difference between split-thickness and full-thickness skin grafts. What tissue layers does a split-thickness skin graft include?

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Correct answer: D — Epidermis and a variable portion of the dermis (not full dermis thickness)

Split-thickness skin grafts (STSG) include the epidermis and a variable portion of the dermis (classified as thin, medium, or thick depending on dermal thickness included). They are harvested using a dermatome from donor sites (typically thigh, buttock) that heal by re-epithelialisation from residual adnexal structures in the remaining dermis. Advantages: easier to take, can cover large defects, donor site heals spontaneously. Disadvantages: poorer cosmetic match, contract more than FTSGs, and have a 'meshed' or shiny appearance. Full-thickness skin grafts include epidermis and the ENTIRE dermis — better cosmetic match but require primary closure of the donor site. The choice depends on defect size, location, and cosmetic requirements.

Reference: BAD Dermatological Surgery; Wound Management