Advantages of split-thickness skin grafts over full-thickness skin grafts include:

D. Split-thickness grafts offer better resistance to infection.

E. Split-thickness grafts survive better on surfaces with compromised blood supply.

DISCUSSION: Split-thickness grafts include all of the epidermis but only a part of the dermis. Full-thickness skin grafts include all of both layers, so surgical closure of the donor wound is necessary whereas the portion of dermis left at the split-thickness skin donor site regenerates a skin covering. Because all layers of the skin are included in a fullthickness skin graft, pigment matching is better and less contraction occurs than with split-thickness grafts. Fullthickness grafts require a better blood supply for survival than the split-thickness grafts because the graft vessels are cut below the level of the dermal branching. Relatively fewer cut vessels are available to absorb nutrients from the wound bed to meet the relatively greater nutritional needs of the thicker graft. The poor resistance of full-thickness grafts to infection precludes their use on contaminated wounds, whereas split-thickness skin, which is more richly supplied with open blood vessels on its underside, is able to survive on compromised surfaces, including granulating wounds contaminated with bacteria.