From the Guidelines
The correct answer is (a) less wound contraction. Full thickness skin grafts have a significant advantage over split thickness grafts because they contract less during healing. This is because full thickness grafts contain the entire dermis layer, which provides structural integrity and maintains the original dimensions of the graft better over time.
- They provide better cosmetic results, as noted in a study from 1, which found that full-thickness skin grafts procured from the sentinel node biopsy site provide an excellent cosmetic result.
- Split thickness grafts, which only contain the epidermis and a portion of the dermis, tend to contract more significantly during healing, potentially leading to cosmetic and functional issues. While full thickness grafts do provide better sensory function (option d) due to preservation of nerve endings, they actually have a lower "take" rate (option b) because they require better vascularity at the recipient site.
- They also don't offer more resistance to infection (option c) compared to split thickness grafts, as this aspect is more dependent on the overall health of the patient and wound care rather than the type of graft used. The reduced contraction of full thickness grafts makes them particularly valuable for grafting areas where contracture would cause functional or cosmetic problems, such as the face, hands, or over joints, as implied by the consideration of margin width in melanomas of intermediate thickness in the study from 1.
From the Research
Comparison of Full-Thickness and Split-Thickness Skin Grafts
- Full-thickness skin grafts have several advantages over split-thickness skin grafts, including:
- Better sensory function: Full-thickness skin grafts contain all layers of the skin, including nerve endings, which can lead to better sensory function in the grafted area 2.
- Less wound contraction: Full-thickness skin grafts are less prone to contraction, which can result in a more aesthetically pleasing outcome 3.
- Better aesthetic results: Full-thickness skin grafts can provide a more natural appearance and texture, making them a better choice for reconstructive surgery in visible areas 2, 4.
- However, the provided studies do not specifically mention "more resistance to infection" or "better take" as advantages of full-thickness skin grafts over split-thickness skin grafts.
- It is worth noting that the choice between full-thickness and split-thickness skin grafts depends on various factors, including the size and location of the wound, the availability of donor sites, and the patient's overall health 5, 6.