Hidden scar for a split-thickness graft: A donor site camouflaging technique

Split-thickness skin grafting (STSG) remains a cornerstone of reconstructive surgery, yet donor-site morbidity and visible scarring continue to pose significant concerns, particularly in patients with high esthetic expectations or increased risk of complications. Traditional donor sites, although reliable, may result in distressing and socially visible scars. We present a simple and reproducible technique for harvesting STSG from the suprapubic skin crease, achieving a nearly invisible scar that is naturally concealed by standard underwear. A fusiform full-thickness skin paddle is elevated along the suprapubic skin crease, secured over a flat metal plate with a thin gauze interface, and harvested using a powered dermatome to obtain a uniform graft while preserving cosmetic outcomes. This technique was applied in a single patient, achieving complete graft take and uneventful donor-site healing. The resulting scar was linear, flat, and well hidden, with high patient satisfaction. This approach provides an effective option for optimizing donor-site management when scar concealment is a priority.