How can a free skin graft survive before new blood vessels grow into it?

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Kidney transplant — transplant British surgeon Andrew Ready flushing a donated kidney during a transplant at Queen Elizabeth Hospital, Birmingham, England, 2006.

When extremely thin pieces of skin are used as a free graft, they are able to survive before new blood vessels form because they obtain sufficient nourishment directly from the serum present in the graft bed to which they are applied.1

Because these grafts are so thin—often described as being the thickness of tissue paper—they require less oxygen and nutrients than thicker tissue, which significantly reduces the risk of the graft failing to survive in its new location. In contrast, full-thickness grafts, which include both the dermis and epidermis, are at a higher risk of failure because they represent the maximum thickness of tissue that can survive without an immediate blood supply.23