A split skin graft, also called a split-thickness graft, uses only the upper layers of the skin rather than its full depth. It is thinner than a full-thickness graft, takes more reliably on a difficult wound bed, and can cover a much larger area.
A skin graft on the scalp is the most common use of this technique after Mohs micrographic surgery, particularly for larger basal cell and squamous cell carcinomas on the crown in patients with thinning hair.
When a split skin graft is used
- Large defects, particularly on the scalp, lower leg and trunk.
- Wounds where a thicker graft would be less likely to take.
- Situations where covering the wound quickly and reliably matters more than an exact colour match.
- As a temporary cover while the area is watched before definitive reconstruction.
What the procedure involves
The graft is shaved from a flat donor area, usually the thigh, using a specialised instrument. It is laid over the wound and secured with stitches, staples or glue, then dressed. The donor site is covered with a dressing and heals on its own over roughly two weeks, in the same way as a graze.
Healing week by week
- Days 1 to 7. Dressings stay in place while the graft takes.
- Weeks 1 to 2. First dressing change. The graft looks red and shiny. The donor site is often more uncomfortable than the graft itself.
- Weeks 2 to 6. The graft settles and firms. The donor site heals over and stays pink for some months.
- Months 3 to 12. Colour and texture continue to mature at both sites.
Appearance and trade-offs
Split grafts are reliable but leave a shiny, flatter patch that differs in colour and texture from the surrounding skin, and hair will not grow through a grafted area of scalp. Where appearance is the priority and the wound allows it, a full-thickness graft or a local flap will usually give a better cosmetic result.
Book a consultation
To discuss Mohs surgery and reconstruction with Miss Nayar, please use the contact form or call the clinic directly.