1. Introduction

2. Surgical Approach

3. Incision

4. Specimen Orientation

5. Excision of the Lesion

6. Hemostasis

7. Lesion Dimensions

a. Measuring and Marking

b. Apply Mineral Oil

c. Excise Graft

8. Skin Graft Harvesting

a. Place Graft

b. Staple Graft

9. Skin Graft Inset

10. Dressings

11. Post-op Remarks

Skin is the largest organ by the surface area of the body and is essential to prevent dehydration, as the first barrier to infection, permit unrestricted movement, and provide a normal profile and appearance. A skin graft is a paper-thin piece of skin that has no fat or other body tissues attached and has been completely removed from its blood supply. Therefore, a skin graft can be transferred anywhere in the body as long as where placed, the so-called recipient site, does have a sufficient blood supply to nourish the skin until new blood vessels can grow into it within a short timeframe. Otherwise, if that does not occur, the graft will shrivel up and die. The downside even of a successful skin graft is the variable final color and inharmonious appearance of the skin, a tendency to contract possibly causing deformities especially limiting motion across joints, and similar healing issues at a second wound, that is the donor site of the graft itself.  Nevertheless, this is a rapidly performed surgical procedure requiring but the simplest of instrumentation for the harvest of that graft that can then permit replacement of extensive skin deficiencies. In this video article, these virtues are displayed as a split-thickness skin graft is used to replace the skin missing following the removal of a large squamous cell skin cancer of the forearm. 


Watch this full-length, narrated surgical video of a squamous cell carcinoma excision with split-thickness skin graft. This was performed by Dr. Geoffrey Hallock during a surgical mission in Honduras with the World Surgical Foundation.

Hospital Leonardo Martinez, Honduras