Thiersch Procedure: Split-Thickness Skin Graft Technique

The Thiersch procedure (split-thickness skin graft, STSG) transplants a thin layer of epidermis and partial dermis from a donor site to a recipient wound.

Steps

1. Donor site selection – thigh, abdomen, upper arm (healthy, elastic skin).
2. Preparation – cleanse and sterilize both sites.
3. Harvest – dermatome shaves a uniform graft (0.012–0.018 inch thick).
4. Recipient bed preparation – debride, ensure vascularized base.
5. Graft placement – lay graft, secure with staples/sutures/glue, ensure contact.
6. Dressing – bolster or tie-over to immobilize.
7. Healing – revascularization in 3–5 days; maturation over weeks/months.

Indications

Burns, large traumatic defects, necrotizing fasciitis excision, contracture release.

STSG contracts less than full-thickness grafts but provides durable coverage.