A skin flap is similar to a graft in that tissue is transplanted. The essential difference is that a flap exists on its own blood supply. This means much larger amounts of tissue can be transported, including muscle if required.
A skin graft involves healthy skin being removed from one area of the body (the donor site) and transplanted to another (the recipient site). The areas of the body most commonly used as a donor site are the leg, inner thigh, upper arm, forearm and buttocks.
Skin grafts are often employed after serious injuries when some of the body’s skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: it can reduce the course of treatment needed (and time in the hospital), and it can improve the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts, the more common type is where a thin layer is removed from a healthy part of the body (the donor section), like peeling a potato, or a full thickness skin graft, which involves pitching and cutting skin away from the donor section. A full thickness skin graft is more risky, in terms of the body accepting the skin, yet it leaves only a scar line on the donor section, similar to a Cesarean section scar. For full thickness skin grafts, the donor section will often heal much more quickly than the injury and is less painful than a partial thickness skin graft.
Skin grafts and flaps can be used to treat a number of different conditions. The most common are:
Simple skin grafts and flaps can be done in a day surgery. More complex procedures are done in an overnight hospital. It varies enormously depending on the type, size and situation. A simple split skin graft may take less than an hour, whilst a complicated free flap could take as long as 10-12 hours.