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ABSTRACT: Excision of cutaneous lesions in the lower limb often results in defects that cannot be closed primarily. In comparison to split-skin grafts, full-thickness skin grafts achieve a better cosmetic outcome but take with more difficulty. We aimed to study the outcome of full-thickness graft resurfacing of such defects. This study included 28 patients who underwent excision of a total of 30 lesions with full-thickness skin grafts. The data gathered included site and size of the lesion, level of excision, method of fixation of the graft, histology results, graft take and presence of donor and recipient complications. The median age of the patients was 87 years. The mean size of the defect was 18.03 cm(2) (roughly 6 x 4 cm(2)). The graft take was good (>80%) in 18 full-thickness skin grafts, while it was partial (50-75%) in 7 patients and was poor (25% or less) in 5 patients. All excision wounds healed without any need for further surgery. Donor site complications occurred in 2 patients. We conclude that, following excision of lower limb lesions, primary full-thickness skin grafting is an effective and safe method of resurfacing defects in the lower limbs with a very low incidence of donor site complications.Dermatology online journal 02/2008; 14(2):4.