Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 8 3 2025 12 22 86 91 EN abhishek sharma Faculty Medical Superintendent, Director of Plastic Surgery Services, Department of Plastic Surgery, ALL IS WELL Multispecialty Hospital, Burhanpur, Madhya Pradesh, India 2025 08 16 Background: Skin grafting is a procedure designed to restore the integrity of the skin. The primary reasons for skin graft failure include seroma, hematoma, and infection. These complications hinder the graft's adherence and revascularization, raising the risk of graft rejection, especially during the early postoperative period and aesthetic outcome later. Objective: The purpose of this study is to analyse graft acceptance and rejection due to seroma or infection, as well as the timing of the first check dressing on the third day compared to the fifth day and assessing the aesthetic outcome. Methods: A comparative and prospective study was conducted at our institution from June 2023 to July 2025 involving 200 patients who underwent split-thickness skin grafting (STSG) and were divided into two groups. In Group A, the initial postoperative dressing was applied on day 3, while in Group B, it was done on day 5. The second postoperative dressing occurred two days after the first. The skin grafted area was evaluated for incidence of seroma ,infection, the percentage of graft uptake and rejection, using both culture sensitivity testing and clinical observation. Results: The findings indicated that the average graft uptake in Group A was 88.5%, compared to 81.93% in Group B during the first dressing with better aesthetic outcome in group A. During the second dressing, Group A showed 88.24% and Group B showed 78.03% Conclusion: Performing the initial postoperative dressing on the third day after skin grafting significantly enhances final graft acceptance and aesthetic outcome.   https://ajs.tums.ac.ir/index.php/ajs/article/view/321