Remove the graft from the cardboard and place it on the wound so the direction of hair growth on the graft matches that on the skin around the defect.
Suture one edge of the graft to its corresponding wound edge by placing simple interrupted or simple continuous 3-0 or 4-0 monofilament nonabsorbable sutures (nylon or polypropylene). Staples can also be used for this attachment.
Smooth the graft over the wound and attach it to the other wound edges at various points with simple interrupted tacking sutures or staples. Manipulate the graft if needed to determine the best fit. If the mesh holes of the graft are not open when the graft is tacked at the other edges, remove the tacking sutures and trim 2 to 3 mm of skin from this edge of the graft before it is sutured or stapled in place. This trimming helps ensure expansion of the mesh holes for adequate drainage of any fluid (blood, exudate, serum) on the wound surface.