Abstract
Skin grafts can be classified into three types: full-thickness skin grafts (FTSGs), splitthickness skin grafts (STSGs), and others (Table 1). The FTSGs consist of epidermis
and the entire dermis including adnexal structures such as hair follicles, sebaceous
glands, and sweat glands. Also, FTSGs contain slight adipose tissue because dermosubcutaneous fat interface is undulated, similar to epidermo-dermal interface. The
STSGs consist of epidermis and a part of dermis. Also, STSGs are subdivided into
thin (0.125-0.275mm), medium (0.275-0.4mm), and thick (0.4-0.75mm) depending
on the amount of dermis. Others include artificial skin grafts (5,6), which are discussed in Chapter 47, pure epidermal sheet grafts (7-10), and composite grafts, which
consist of at least two tissue components such as skin [either pure epidermis, dermis (11), partial-thickness skin, or full-thickness skin], fat, cartilage, muscle, fascia,
and bone. Pure epidermal sheet grafts are useful to treat palmoplantar wounds
through epithelial-mesenchymal interactions (10) and to treat vitiligo (7,8). Composite grafts are sometimes useful to reconstruct nasal alar rim defects. Composite
grafts can be narrowly defined as the combination of full-thickness skin with adipose tissue or cartilage. Such grafts do not take easily because these tissues cannot
transport tissue fluid to the grafted dermis and also act as obstacles to revascularization of the graft. Dermal grafts, dermal fat grafts, mucous grafts are also occasionally used for the special component augmentations.