Mastering grafts and flaps in dermatologic surgery: A narrative review

A skin graft is a sheet of skin (epidermis with or without varying amounts of dermis) that is detached from its own blood supply and placed in a new area of the body while a flap is a tissue that is moved from one part of the body to another with a vascular pedicle, which can be left intact or transected once the flap has developed revascularisation at the recipient site. It may also be reconnected to a new blood supply at the recipient site as a free flap. This review article explores the critical role of skin grafts and flaps in dermatological surgery, emphasising their applications in reconstructive procedures, especially after the excision of benign and malignant lesions on the face. Skin grafts, including split-thickness (STSGs) and full-thickness (FTSGs) skin grafts, are analysed for their indications, techniques, and outcomes, while various flap types are discussed in terms of their vascular supply, design, and functional benefits. Additionally, complications have been reviewed to provide a better understanding of the challenges faced in clinical practice. By synthesising current literature and clinical experiences, this article aims to serve as a valuable resource for dermatologists and plastic surgeons in improving patient outcomes through effective graft and flap utilisation.