title: Optimizing aesthetic results in skin grafting.
abstract: The aesthetic goal in skin grafting is to provide a cosmetically pleasing coverage of soft tissue defects while minimizing donor site morbidity. A skin graft should blend well with the color and texture of the surrounding skin, reduce wound size, and not interfere with the function  of the reconstructed part. This review examines the key components of choosing the appropriate donor skin for a variety of defects. The decision-making process is based on the anatomic location of the defect; donor site availability; and graft size, thickness, and pigmentation. The aesthetic  implications of using a sheet graft versus a meshed graft versus an expanded graft are discussed. Aside from addressing the aesthetic needs of the defect, attention is paid to the functional goals of the reconstructed part and reduced donor site morbidity. Partial graft failure  can have significant deleterious effects on the aesthetic outcome of skin grafts. The need for further grafting or healing by secondary intention may result in additional scarring and deformity. Recommendations for improvement in graft take and infection control are presented.
authors.affiliation: Department of Surgery, Division of Plastic Surgery, University of Louisville, Louisville, KY 40292, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Hazani
authors.forename: Ryan
authors.initials: R
authors.lastname: Whitney
authors.forename: Bradon J
authors.initials: BJ
authors.lastname: Wilhelmi
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000517:prevention & control*; D004954:Esthetics; D006801:Humans; D016038:Skin Transplantation / Q000379:methods* / Q000592:standards; D013524:Surgical Flaps / Q000592:standards*; D014945:Wound Healing