Graft harvesting and application: A comprehensive review

Background Skin grafting remains a cornerstone in reconstructive surgery. The procedure is essential in the management of burns, trauma, oncologic resections, and chronic wounds. Despite its historical relevance, new advances in surgical techniques and bioengineering have significantly expanded its applications.
Methods A systematic literature review was conducted in PubMed, Scopus, and Web of Science databases focusing on publications from 2000 to 2024. Keywords included skin graft, harvesting techniques, integration physiology, bioengineered grafts, and complications. Only studies related to surgery and bioengineering were included.
Results Autologous grafts remain the gold standard due to superior integration and reduced immunological rejection. However, acellular dermal matrices, stem cell–seeded scaffolds, and 3D-printed constructs represent promising alternatives. Integration physiology follows three phases: plasmatic imbibition, inosculation, and angiogenesis. Complication rates vary between 5–25%, with infection, necrosis, and graft failure as the most frequent.
Conclusion Traditional grafting techniques continue to demonstrate efficacy. Nonetheless, advances in regenerative medicine and bioengineering are paving the way for next-generation grafts that may offer enhanced survival, integration, and functional outcomes.