Optimized nursing strategies for skin graft outcomes: a narrative review of current evidence

Skin grafting remains a cornerstone technique for repairing full-thickness skin defects. Its success depends on the coordinated optimization of graft survival, healing quality, functional recovery, and aesthetic outcomes. In recent years, a growing array of novel wound dressings, bioactive agents, cell-based therapies, and physical adjunctive modalities have expanded clinical options but simultaneously introduced complexity in balancing benefits against risks. In this review, we construct an evidence-based decision-making framework to guide clinical practice throughout the entire skin grafting process. We first focus on graft immobilization and adherence, critically appraising techniques to optimize graft survival. We then examine strategies for accelerated healing and pain reduction, comparing optimization approaches for donor and recipient sites. Finally, we analyze long-term efficacy and aesthetic outcomes, dissecting the trade-offs among different techniques in functional rehabilitation and scar management. By synthesizing high-quality evidence within this structured framework, this review aims to provide clinicians with a practical, evidence-anchored roadmap for individualized perioperative care.