Skin Graft:
A skin graft is a procedure performed where healthy skin is removed from one area of the body, the
donor site, and transplanted to another, the recipient site. The areas of the body that are most
commonly used as donor sites for skin grafts are the leg, inner thigh, upper arm, forearm and
buttocks.
There are two main types of skin grafts:
Split or partial thickness graft – Most common type of graft. The epidermis and part of the dermis
are removed from the donor site and transplanted on the damaged area. It is possible that the graft
can be spread over a mesh to increase the surface area covered. This type of graft heals relatively
quickly but is quite fragile and not suitable for deep or infected wounds and the cosmetic result is
often not good.
The donor site heals by a process of re-epithelialisation. Epithelial cells migrate across the wound
surface from the rim of the wound and the edges of various structures in the dermal layer, such as
sebaceous glands and hair follicles.
Full thickness graft – The entire epidermis and dermis are transplanted to the recipient site.
Although the cosmetic effects can be good, full thickness grafts are only suitable for small areas. The
donor site needs to either be closed with stiches, or have a partial thickness graft transplanted.
Skin Flap:
A skin flap is similar to a graft. The essential difference between the two is that a flap exists on it’s
own blood supply. This means that much larger amounts of tissue can be transported, including
muscle if required. There are many different types of surgical techniques used to create flaps, but
they can be broadly classified into the following groups:

Local flap– This is when the donor site is immediately adjacent to the recipient site. The
required area of skin and tissue is moved without interrupting the blood supply.

Distant flap– Distant flap is when a flap is from an entirely different area of the body, for
example, a flap taken from the leg might be used for a wound on the neck. This may be
achieved over the course of two or more operations depending on the complexity of the
reconstruction.

Free Flap– A Free flap is also a distant flap but the
procedure is done in one stage using microsurgery
to repair the blood and donor vessels establishing
immediate blood flow.
Reference:
http://healthtopics.hcf.com.au/Skin
GraftsFlaps.aspx
http://www.joannabriggs.edu.au/pd
f/BPISEng_6_2.pdf