[Free skin transplants].

The considerations of defect-closure in skin surgery are associated with the question--flap or graft? Different areas and conditions require individualized approaches to reconstruction. A great variety of ingenious flaps and the new method of skin-expander promote and favourise these techniques in surgical defect closure. Anyway the different grafts are still main-topics in skin surgery. Generally there exist three types of grafts. The split-thickness skin grafts, in its various modifications, are useful for functional closures of defects, while full-thickness skin grafts give better cosmetic results. The composite graft, containing epidermis, full dermis and cartilage, fits for reconstruction of contoured defects at the nose and ear. The nutrition of this special graft is limited by the contact-periphery between graft and defectborder. In contrast the survival of the other types of grafts depends on the undersurface, the degree of granulation tissue in the wound bed. The attention of many technical details, the skillness of the surgeon and some artistic considerations are the guarantors of successful grafting and of good cosmetic results.