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Greenhalgh. Plast Aesthet Res 2024;11:27 https://dx.doi.org/10.20517/2347-9264.2024.43 Page 9 of 13

Figure 8. (A) A donor site harvested in a circumferential fashion at the upper thigh can easily be hidden with shorts (B); (C) the lower
back is an excellent area for a donor site, especially in children. It can be covered with shorts and the back tends to scar less than other
areas.

Figure 9. This donor site of the upper chest was taken because it was near the recipient site. It was placed in an obviously cosmetic area
that would be seen with any opening of a shirt or V-neck. A site in the upper thigh or lower back would have been a much better choice.

For the fingers, wrap grafts circumferentially around the fingers. The best option is to have seams on the
fourth webspace for the fifth and ring fingers, and the second webspace for the index and middle fingers.
The seam on the ulnar side of thumb works well. It is essential for all skin grafts to have aggressive
occupational/physical therapy support since contractures will occur if just relying on grafting alone.
Pressure garments and silicone also help. One must remember that burns, especially skin grafts, get redder
and thicker for 3-4 months before fading over the next several months. Complete maturation may take
longer than a year. It is during this prolonged period when aggressive occupational/physical therapy and
scar massage are essential to optimize outcomes.