Skin grafts and flaps after skin cancer surgery

Cancer Research UK describes the two and the difference that matters to the result. For a graft, a surgeon shaves or cuts a sheet of skin from a donor site, usually somewhere not too obvious such as the inner thigh, and stitches it over the defect; a shaved donor site heals on its own without stitches, a cut one is stitched. For a flap, the incision is deeper, the skin is left partly connected to its original site so that it keeps its blood supply, and it is rotated or advanced into the defect and stitched in place, with the donor area closed with stitches or staples or occasionally with a graft of its own. Only specially trained dermatologists or plastic surgeons do flaps, and more than one operation is sometimes needed. After either, the team watch the wound closely to check it is getting a good blood supply.

The third option is the one people are least often told about in advance. The BAD's Mohs leaflet lists healing on its own, over several weeks and up to two months under a dressing, as one of five ways of dealing with the wound, alongside stitches, a graft, a flap and referral to another surgical team. On the face, near the eyelid, nose, ear and lip, the reconstruction may be handed to an oculoplastic, maxillofacial or plastic surgeon, and asking which team will close the wound is a separate question from asking who will remove the cancer.