Hand & Upper Extremity Skin Grafting

Split-thickness Skin Graft (STSG):

• In an STSG procedure, Dr. Pournaras will harvest a thin layer of skin, typically from the thigh or abdomen.
  • This type of graft is often used for covering larger areas of skin loss or burns on the hand, as it provides good coverage and promotes healing.
  • STSGs require a well-vascularized wound bed for successful graft take, and they may require meshing to increase the surface area and allow for drainage of fluids.

Full-thickness Skin Graft (FTSG):

• • FTSGs involve using a thicker layer of skin from a donor site to the hand.
  • This type of graft is commonly used for more minor defects or injuries on the hand, where a thicker layer is needed to return function and cosmetic appearance.
  • FTSGs provide better color match and texture to the surrounding, improving cosmetic outcomes.

Composite Graft:

• • Composite grafts consist of skin and underlying tissue, such as fat or cartilage, and are often used for reconstructing specific structures or features of the hand, such as the fingertip.
  • These grafts are typically harvested from areas with similar tissue characteristics, such as the earlobe or the other fingers.
  • Composite grafts require meticulous surgical technique and careful post-operative care to ensure graft survival and functionality.

Free Flap Reconstruction:

• • Free flap reconstruction involves the transfer of skin, along with its blood supply, from a distant donor site to the hand using microsurgical techniques.
  • This complex procedure is reserved for cases of extensive soft tissue loss or complex hand injuries where other grafting techniques are not feasible.
  • Free flap reconstruction offers the advantage of providing large amounts of vascularized tissue to cover defects and restore hand function.