Average Graft Uptake After Split-Thickness Skin Grafting
The average graft uptake after split-thickness skin grafting (SSG) ranges from 87.5% to 96.7%, with conventional dressing techniques achieving approximately 87.5% uptake and negative pressure dressing techniques achieving approximately 96.7% uptake.
Graft Uptake Rates by Technique
Conventional Dressing Method
- Standard SSG with conventional dressing (Vaseline gauze and cotton pads) achieves an average graft take of 87.5% (range: 70-100%) in burn patients at 9 days post-grafting 1.
- The variability in uptake (SD: 8.73) reflects differences in wound bed quality and grafting conditions 1.
Negative Pressure Dressing Method
- Negative pressure dressing at 80 mm Hg for 4 days significantly improves graft uptake to an average of 96.7% (range: 90-100%) at 9 days post-grafting 1.
- This represents a statistically significant improvement (p<0.001) compared to conventional dressing 1.
- The improved uptake is particularly valuable when wound bed conditions are less-than-ideal 1.
Factors Affecting Graft Uptake
Graft Thickness Considerations
- Thinner grafts (0.2mm) demonstrate the greatest epithelialization scores and highest rates of complete wound epithelialization in both recipient and donor sites compared to 0.3mm or 0.4mm grafts 2.
- Graft thickness affects early healing parameters but all thicknesses can achieve successful uptake when properly applied 2.
Patient Population Variables
- In high-risk diabetic patients with chronic lower extremity wounds, complete graft incorporation and healing occurs in 69.1% of cases 3.
- Wound location (plantar vs non-plantar) and presence of diabetes do not significantly affect healing rates (P > 0.05) 3.
- Dialysis-dependent patients show higher revision rates (46.2% vs 14.8%, P = 0.01) but ultimately achieve similar cumulative healing rates 3.
Clinical Pitfalls and Optimization
The key to achieving optimal graft uptake is ensuring a well-vascularized recipient bed. When grafts are placed on healthy vascular tissue beds, particularly well-vascularized muscle beds, uptake rates remain high even with subsequent radiotherapy 4.