The essential nature of a burn is the thermal, and or, chemical destruction of skin and underlying tissue. Skin grafting is always necessary for treating full thickness (third-degree) burns, but is only occasionally required for partial-thickness (second-degree) burns and rarely needed to repair superficial (first-degree) burns. In addition, the procedure is used to mitigate the functional and aesthetic damage caused by some burns.

Burn treatment consists of debridement of devitalized tissue followed by skin grafting. This should occur as soon as possible, depending on the stability of the patient. Attempts to preserve as much tissue as possible are initiated by tangential excision of the burn. Theoretically, the skin graft can be of varying thickness, but usually is of the split thickness type. It can be applied as sheet grafts or meshed grafts to increase surface area. All attempts are made to minimize the meshed ratio to improve cosmesis. If larger ratio meshing is needed for coverage because of a lack of donor availability, it is common to use a combination of autologous skin and cadaveric skin. The cadaveric skin is placed over the meshed skin, creating a closed wound that allows the meshed skin to heal underneath the cadaveric skin. After 3 weeks, the cadaveric skin undergoes necrosis and sloughs, leaving the healed autologous skin intact. The location of the burn and the total body surface area involved determine both the thickness and the location of the donor site.