between debridement and graft operations to assist an infected wound in remaining clean for a period of time before new skin is applied. Skin grafting can also be seen as a skin transplant. Z-plasty This is based upon the principle of mobilizing a full segment of skin from an area to the site needing tissue replacement. The flaps are triangularly shaped opposite each other. It can be used in direct excision and closure of a bad scar to produce a better looking and healing scar. It helps to elongate and break up a linear scar. It also gives a good result in the release of linear contractures. Z-plasty is described as the plastic surgeon's best friend being of paramount importance and a frequently used method in both single multiple forms. Risks Risks for the skin graft surgery are: Bleeding Infection Loss of grafted skin Nerve damage Graft-versus-host disease Rejection may occur in xenografts. To prevent this, the person receiving the graft usually must be treated with long-term immunosuppressant drugs. Prognosis Most skin grafts are successful, but in some cases grafts do not heal well and may require repeat grafting. The graft should also be monitored for good circulation. Recovery time from skin grafting can be long. Graft recipients wear compression garments for several months and are at risk for depression and anxiety consequent to long-term pain and loss of function. History Skin grafting, in more rudimentary forms, has been practiced since ancient times. The Ebers Papyrus of ancient Egypt contains a brief treatise on xenografting. Around 500 years later, members of the Hindu Kamma caste are described as performing skin grafts which included the usage of subcutaneous fat. The 2nd century AD Greek philosopher Celsus is also known to have developed a method to reconstruct the foreskins of Jewish men using skin grafts, as circumcision was considered barbaric in Greek and Roman society. More modern uses of skin grafting were described in the mid-to-late 19th century, including Reverdin's use of the pinch graft in 1869; Ollier's and Thiersch's uses of the split-thickness graft in 1872 and 1886, respectively; and Wolfe's and Krause's use of the full-thickness graft in 1875 and 1893, respectively. John Harvey Girdner demonstrated skin graft transplant from a deceased donor in 1880. Today, skin grafting is commonly used in dermatologic surgery. Recently Reverdin's technique is used but with very small (less than 3 mm diameter). Such small