A split skin graft uses the upper layers of the skin to cover larger wounds reliably, most often on the scalp. Planned and carried out by Consultant Plastic Surgeon Miss Rakhee Nayar.
Women in the UK dual-trained in Mohs and plastic surgery
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
A thinner graft
What is a Split Skin Graft?
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.
Choosing the repair
When is a Split Skin Graft Used?
The scalp is the most common site for this technique after Mohs surgery, particularly for larger cancers on the crown in people with thinning hair.
It is also used on the lower leg and the body, where a large wound needs reliable cover.
Where appearance is the priority and the wound allows it, a full-thickness graft or a local flap will usually look better.
Large wounds, particularly on the scalp, lower leg and body.
Wounds where a thicker graft would be less likely to take.
Situations where reliable cover matters more than an exact colour match.
As a temporary cover while an area is watched before final reconstruction.
Planned around you
Strengths and Trade-Offs
Split grafts are reliable and can cover large areas, but they look different from the surrounding skin.
Knowing both sides helps you and Miss Nayar choose the right repair together.
Reliable Take
A thinner graft takes more reliably on a difficult wound bed.
Large Coverage
It can cover a much larger area than a full-thickness graft.
Different Appearance
It leaves a shiny, flatter patch that differs in colour and texture from the surrounding skin.
No Hair Regrowth
Hair will not grow through a grafted area of the scalp.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Split Skin Grafts Are Used
Split grafts are chosen mainly for large wounds away from the central face, where reliable healing is the priority.
Read about the other reconstruction options: direct closure, healing by secondary intention, local flap, full-thickness skin graft, nasolabial flap and forehead flap.
The Scalp
The Crown
The Lower Leg
The Body
Large Temporary Cover
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
The wound and the donor area are numbed with local anaesthetic.
A thin layer of skin is shaved from a flat donor area, usually the thigh, using a specialised instrument.
The graft is laid over the wound and secured with stitches, staples or glue.
The graft is dressed and the dressing left in place while it takes.
The donor site is covered and heals on its own over about two weeks, like a graze.
Other options
Other Reconstruction Options
Where appearance matters most and the wound allows it, one of these repairs may give a better cosmetic result.
Full-Thickness Skin Graft
Skin taken from a hidden donor site and laid into the wound. Read more
Local Flap
Neighbouring skin moved across on its own blood supply for a close match. Read more
Healing by Secondary Intention
The wound is dressed and left to heal on its own, in the right sites. Read more
Direct Closure
A fine line of stitches, placed in the natural creases of the face. Read more
Healing week by week
Recovery and Healing
Recovery involves two sites: the graft and the donor area. Miss Rakhee Nayar gives you a clear aftercare plan for both and sees you again to check them.
- 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 in the first couple of weeks.
- Weeks 2 to 6: the graft settles and firms, and the donor site heals over.
- The donor site can stay pink for some months.
- Months 3 to 12: colour and texture continue to mature at both sites.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
Why is the donor site sore?
The donor site is a shallow wound, like a large graze, and it is often more uncomfortable than the graft for the first week or two. It heals on its own over about two weeks.
Will hair grow back on the graft?
No. Hair does not grow through a grafted area of the scalp. If that matters to you, discuss other options at consultation.
Can it be improved later?
Sometimes. A split graft can be used as temporary cover while an area is watched, with a different repair considered later.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All surgery leaves a scar. A split graft leaves a flatter, shinier patch, and the donor site usually fades to a paler area over several months.