Background: Split skin grafting (SSG) is a widely practiced reconstructive technique for managing skin loss due to trauma, burns, infections, and chronic ulcers. Despite its frequent use, graft failure remains a significant challenge influenced by multiple patient-, wound-, and procedure-related factors. This study aimed to identify determinants affecting the success of SSG uptake in patients presenting with skin loss.

Methods: An observational study was conducted on 87 patients with skin loss requiring SSG. Baseline demographic, clinical, laboratory, and microbiological parameters were recorded, along with perioperative factors such as dressing material, antibiotic therapy, and timing of surgery. Graft uptake was assessed and categorized as complete, partial, or failed. Statistical analysis included descriptive measures and bivariate comparisons to identify predictors of successful grafting.

Results: The mean age of patients was 46.1 ± 15.8 years, with a male predominance. The most common causes of skin loss were burns (33.3%), necrotizing fasciitis (19.5%), and diabetic ulcers (18.4%). The mean body surface area affected was 7.4 ± 11.0%. Laboratory evaluation revealed mean hemoglobin of 10.8 ± 2.8 g/dL and mean fasting blood sugar of 117.7 ± 55.5 mg/dL. Complete graft uptake was achieved in 47.1% of patients, partial in 49.4%, and failure in 3.4%. Age was significantly associated with graft success, with younger patients showing better outcomes (p < 0.05). Other factors, including wound size, microbial isolates, dressing material, antibiotic type, and hospital stay, did not significantly affect graft uptake.

Conclusion: SSG uptake is strongly influenced by patient age, while other clinical, laboratory, and perioperative factors demonstrated no significant impact. Optimizing patient selection and perioperative care, particularly in elderly patients, may improve graft outcomes.