Skin grafting is a central component of the reconstructive ladder, which can provide definitive soft tissue coverage of traumatic wounds. Split thickness skin grafting (STSG) refers to the harvest of the entire epidermis and part of the dermis, leaving adnexal structures at the donor site from which re-epithelialization can occur. The utility of STSGs has rendered this technique more versatile than its full-thickness counterpart, more commonly performed given their utility and ease in application for a variety of wound types. More recently, various synthetic and biologic alternatives to skin grafts have been developed to provide soft tissue wound coverage for patients when skin graft harvest is not feasible. Herein, we discuss the stepwise harvest of STSGs and discuss contemporary skin graft substitutes for the management of traumatic wounds.