Skin graft
A procedure that moves a piece of healthy skin from one part of the body to cover a wound that cannot heal or be stitched on its own.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A skin graft moves healthy skin to cover a wound that cannot be stitched or heal on its own.
- There are always two wounds: the area being covered and the donor site where the skin is taken from.
- A graft has no blood supply at first and must 'take' from the wound bed, so it can partly or fully fail — smoking and movement increase that risk.
- Whether the graft has taken is usually clear within a week or two, when the first dressing is checked.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Covers a wound that could not be closed with stitches or left to heal alone
A graft may not take on a poorly vascularised bed, such as exposed bone, cartilage or tendon without covering — a flap is often needed instead.
The graft dressing is usually left undisturbed so the graft is not dislodged. Keep the area still and, for a limb, often elevated. Some discomfort at both...
Clear, written instructions for both the graft and the donor site.
The graft dressing is usually left undisturbed so the graft is not dislodged. Keep the area still and, for a limb...
The first dressing is checked to see how well the graft has taken. A split-thickness donor site is often the...
A split-thickness donor site usually heals over in about three to four weeks. The graft becomes more secure; you...
The graft and donor scars soften and settle, though colour and texture differences can be long-lasting. Massage...
What is a skin graft?
A skin graft moves healthy skin from one part of the body (the donor site) to cover a wound somewhere else that cannot be closed with stitches or left to heal on its own. It is often used after removing a skin cancer, after a burn or injury, or for a wound that is not healing.
There are two main types. A split-thickness graft takes the top layers of skin and is used for larger areas; the donor site heals over by itself, a bit like a graze. A full-thickness graft takes all the layers of skin and is used for smaller areas where appearance matters, such as the face or hand; the donor site is stitched closed.
A graft has no blood supply of its own at first. It survives by soaking up nutrients from the wound bed and then growing new blood vessels into it — this is called the graft 'taking'. For that to happen, the wound bed must be healthy and the graft must stay still and protected.
A graft is not the same as a flap. A flap keeps its own blood supply; a graft does not, so it depends entirely on the wound bed to survive. Your surgeon chooses between them based on the wound and where it is.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Split-thickness vs full-thickness graft
| Split-thickness | Full-thickness | |
|---|---|---|
| Skin taken | Upper layers only | All layers of skin |
| Used for | Larger wounds | Smaller, visible areas |
| Donor site | Heals by itself, like a graze | Stitched closed |
| Look and durability | Thinner, can differ in colour | Better match, more hard-wearing |
Your surgeon chooses the type based on the size and site of the wound and how the result needs to look and wear.
Preparing for your surgery
- Make sure you understand why a graft is needed, which type is planned, and where the donor skin will be taken from.
- Stop smoking and avoid nicotine if you can — smoking reduces blood supply and is one of the biggest risks to a graft taking.
- Tell the team about blood-thinning medicines, diabetes, steroids or anything that affects healing.
- Ask how long the donor site will take to heal and how it should be cared for.
- Arrange time off and help at home, especially for a leg graft where you may need to rest and elevate the limb.
- Arrange a lift home if you are having sedation or a general anaesthetic.
- Have comfortable clothing and any dressings or supplies you are advised to get ready.
What happens
Depending on the size and site, a graft may be done under local anaesthetic, sedation or general anaesthetic. First the surgeon prepares the wound (the recipient site) so it has a clean, healthy bed. Then a piece of skin is taken from the donor site — shaved off in thin layers for a split-thickness graft, or cut out and stitched closed for a full-thickness graft.
The graft is laid onto the wound and held in place with stitches, glue, staples or a special dressing, sometimes with a small bolster or sponge pressed over it to keep it still and in contact with the bed. Both the graft and the donor site are dressed.
The first dressing is usually left undisturbed for several days so the graft is not dislodged while it settles, then checked to see how well it has taken.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A graft may not take on a poorly vascularised bed, such as exposed bone, cartilage or tendon without covering — a flap is often needed instead.
- Wounds that are infected or have a lot of dead tissue need preparing first before a graft can be placed.
- People who cannot keep the area still or rest a limb may not get a good result, as movement disrupts a graft.
- Where appearance is critical and the wound bed is suitable, a flap may give a better match than a split-thickness graft.
Delay surgery if…
- The wound is infected or not yet clean and healthy.
- Blood-thinning medicines need adjusting and this has not been arranged.
- Diabetes or another healing problem is poorly controlled.
- You are still smoking and there is time to stop first, as this strongly affects graft survival.
- You cannot yet arrange the rest, elevation or dressing care the graft will need.
Alternatives to discuss
- Closing the wound directly with stitches if it is small enough.
- Letting a wound heal by itself (healing by secondary intention) where appropriate.
- A local or free flap when the wound bed cannot support a graft.
- Specialist dressings or negative-pressure (vacuum) therapy to prepare or close some wounds.
- Non-surgical management in selected frail patients.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Covers a wound that could not be closed with stitches or left to heal alone
- Helps a difficult or non-healing wound to close
- Often gives a quicker, more reliable cover than waiting for a large wound to heal by itself
- A full-thickness graft can give a good colour and contour match on the face or hand
- Can be done at the same time as removing a skin cancer
Risks & complications
- Bruising, swelling and discomfort at both the graft and the donor site
- The donor site feeling sore, raw or itchy as it heals (especially a split-thickness donor site)
- Colour or texture differences between the graft and surrounding skin
- A visible patch or net-like pattern where the graft is
- Part of the graft not taking and needing extra healing time or a repeat graft
- Infection of the graft or donor site
- Bleeding or a collection of blood or fluid under the graft, which can lift it off
- Slow healing of the donor site, particularly in older people or those with poor healing
- Complete graft failure needing the procedure to be done again
- Noticeable or raised scarring at either site
- Long-term colour change, tightness or sensitivity of the grafted skin
A graft depends entirely on the wound bed for its blood supply, so anything that reduces blood flow or disturbs the graft — smoking, movement, bleeding, infection or pressure — can stop it taking. There are always two wounds, and the donor site can sometimes be more uncomfortable than the graft itself. Ask your surgeon how likely the graft is to take in your situation, and what the plan is if part of it fails.
Published figures to discuss
How well a graft takes depends heavily on the wound bed, the type of graft, the patient's circulation and healing, and whether the area is kept still. Partial loss of a graft is common and often heals with dressings; complete failure is less common but more likely on poor beds or in smokers. Reported figures vary widely between settings, so cautious, qualitative wording is used here rather than a single rate.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Split-thickness donor-site healing time | Usually about 3–4 weeks | Slower in older people or those with poor healing, when dressings are continued until healed. | Guide sourcesClinical context |
| Partial graft loss | Common to some degree; usually heals with dressings | Smoking, movement, bleeding under the graft and infection all increase the risk. | Full-thickness skin grafts — StatPearls (NCBI)ncbi.nlm.nih.govSource-linked context |
| Complete graft failure needing a repeat | Less common, but more likely on poorly vascularised beds or in smokers | Reported rates vary widely by wound type and setting, so no single figure is reliable. | Full-thickness skin grafts — StatPearls (NCBI)ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery has two parts: the grafted area and the donor site. The graft needs to be kept still and protected while it takes, and the donor site needs its own care while it heals over.
- A sore, raw or weepy donor site that crusts over and heals like a graze (split-thickness)
- A graft that looks red, shiny or patchy at first before settling
- Itching as both sites heal
- Tightness or a slightly sunken or raised patch where the graft is
- Colour and texture differences that may not fully match the surrounding skin
Aftercare
- Keep the graft still and protected, and avoid knocking, stretching or pressing on it while it takes.
- For a limb graft, rest and elevate the area as advised to reduce swelling.
- Care for the donor site as instructed and keep dressings dry until told otherwise.
- Do not smoke, as this reduces the blood supply the graft needs.
- Once healed, moisturise the graft and donor site, and massage if advised, to help them settle.
- Protect grafted skin from the sun, as it can burn and discolour easily.
- Attend dressing changes and follow-up so healing can be checked.
- Watch for signs of infection at both sites and know who to contact.
- Donor-site and graft care instructions understood
- Help at home arranged, especially for a leg graft
- Dressings and supplies ready
- Time off work or activity booked
- Plan to keep the limb elevated if relevant
- Moisturiser and sun protection for later
- Clinic contact number saved for problems
Scars and how they heal
A skin graft always leaves marks at two places: the grafted area and the donor site. The grafted skin may differ in colour and texture from the skin around it, can look slightly sunken or shiny, and a meshed graft may leave a net-like pattern. A split-thickness donor site often heals as a flat, pale or slightly discoloured patch; a full-thickness donor site leaves a stitched scar line. Sun protection and moisturising help both settle, but some difference is usually permanent.
⚠ Get urgent help if…
- Increasing redness, heat, swelling or pus at the graft or donor site (infection)
- Spreading redness with fever or feeling unwell
- The graft turning dark, black or coming away from the wound
- Bleeding or a tense swelling under the graft
- A donor site that becomes more painful, smelly or stops healing
- The dressing becoming soaked or falling off before it is due to be changed
- Worsening rather than improving pain at either site
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the graft takes well, the wound is covered, and both sites heal. It is common for small areas of a graft not to take, and this often heals with dressings, but a larger failure may mean a repeat graft. Even a successful graft rarely matches the surrounding skin perfectly in colour or texture, and it may stay slightly different long-term.
Whether the graft has taken is usually clear when the first dressing is checked. Your surgeon will explain what to expect for the final look and how long it takes to settle.
Once a graft has fully taken and healed, it generally lasts well as durable skin cover. Full-thickness grafts tend to be more hard-wearing and a better cosmetic match than split-thickness grafts. Grafted skin can stay drier, less stretchy and more sensitive to the sun, so moisturising and sun protection remain helpful long-term. If a graft was done for skin cancer, the usual skin-cancer follow-up and self-checks still apply.
Combining with other procedures
A skin graft is often done at the same time as removing a skin cancer or other lesion, to close the gap left behind. It may also be combined with, or chosen instead of, a flap depending on the wound. Sometimes a graft and a flap are used together for a complex wound. Your surgeon will explain why a graft is the right choice for your situation.
Follow-up & long-term care
You will usually be seen within a week or two to check how the graft has taken and to care for the donor site, with further reviews as both sites heal. If the graft was done for skin cancer, you will also get the cancer results and a follow-up plan. You should be told how to look after the graft and donor site long-term and who to contact with problems.
- Moisturise grafted and donor skin regularly once healed, as it can be dry
- Protect grafted skin from the sun, as it burns and discolours easily
- Massage the graft if advised, to help it soften
- Watch for any breakdown or change in the grafted area and report it
- Continue skin-cancer follow-up and self-checks if the graft followed cancer surgery
Revision and secondary surgery reality
- Areas that do not take are common and often heal with dressings rather than more surgery.
- A larger failure may need the graft redoing once the wound bed is healthy again.
- A poorly matched or contracted graft can sometimes be revised or replaced with a flap later.
- Scars at the donor site or graft can occasionally be revised once fully healed.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear, written instructions for both the graft and the donor site.
- Planned dressing changes and reviews to check the graft has taken.
- A named contact for problems such as bleeding, infection or graft loss.
- Advice on rest, elevation, moisturising and sun protection.
- If cancer-related, a clear process for results and ongoing skin-cancer follow-up.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type and size of graft (split-thickness or full-thickness) and the area covered
- The complexity and site of the wound being reconstructed
- Local anaesthetic, sedation or general anaesthetic, and theatre or facility fees
- Whether it is combined with another procedure such as skin cancer removal
- Dressings, dressing changes and the number of follow-up appointments
- Any further surgery if the graft does not fully take
- The surgeon's fee and what the procedure includes
- Anaesthetic or sedation fees
- Facility or theatre fees
- Dressings, dressing changes and follow-up appointments
- Whether donor-site care is included
- What happens, and what it costs, if part of the graft fails and needs redoing
- Who to contact for problems and how results (if cancer-related) are given
On the NHS? Skin grafting is routinely done on the NHS when clinically needed, such as after skin cancer surgery, burns or injuries; private care may be used for speed or choice.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that there will be a second wound at the donor site.
- Not warning that grafts can partly or fully fail, and what that would mean.
- Underplaying how different the grafted skin may look and feel.
- No clear plan for donor-site care, dressing changes or who to contact.
- Not discussing how smoking affects graft survival.
Marketing red flags
- Implying a graft will match the surrounding skin perfectly.
- Not mentioning the donor site or its recovery.
- Promising a guaranteed 'take' with no meaningful risk of failure.
- Pushing a graft when a flap would clearly give a better result for the site.
- No discussion of aftercare, rest or dressing changes.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Why is a graft the best option for my wound rather than a flap or stitches?
- Which type of graft will I have, and where will the donor skin come from?
- How likely is the graft to take in my case, and what raises that risk?
- How sore will the donor site be, and how long until it heals?
- What is the plan if part of the graft does not take?
- How should I care for the graft and donor site, and what will the final look be?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Where is the skin taken from?
Does the donor site hurt more than the graft?
What does it mean if the graft 'doesn't take'?
Will the grafted skin match the rest of my skin?
How long until I can get back to normal?
Can I have this on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Skin cancer treatment (skin grafts and reconstruction) Full-thickness skin grafts — StatPearls (NCBI) South Tees Hospitals NHS — Skin grafting and donor site care University Hospitals Sussex NHS — Split-thickness graft and donor site St George's NHS — Skin grafts and donor sites (PDF)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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