Use of allogenic dermis for radial forearm free flap donor site coverage.
OBJECTIVE
The radial forearm free flap has become the method of choice for reconstruction of head and neck defects following oncologic ablation. Harvesting of a radial forearm free flap leaves a donor site defect. This is most commonly closed with a split-thickness skin graft. Morbidity, most commonly owing to a lack of graft take over the tendons, can be quite high. Recently, an acellular matrix (Alloderm) has been advocated to decrease complications at the radial forearm donor site, as well as obviate taking a split-thickness skin graft from the thigh.


METHODS
Tertiary referral academic centre. Retrospective chart review of 15 patients. Five patients received allogenic dermis, 10 patients received split-thickness skin grafting to the radial forearm donor site.


RESULTS
Patients with allogenic dermis took between 12 and 16 weeks to heal completely. Patients undergoing split-thickness skin graft were completely healed within 4 to 6 weeks. Cosmesis was judged to be marginally better in the allogenic dermis group. Allogenic dermis placement had a greater impact on hand function owing to prolonged healing, whereas patients with split-thickness skin graft required wound care at the thigh for a 2- to 3-week period owing to the harvesting of the skin graft.


CONCLUSIONS
Allogenic dermis may be a viable alternative to split-thickness skin grafting and radial forearm free flap donor sites. Prolonged healing with subsequent increased health care services use needs to be addressed.
Wax
Mark K
MK
Department of Otolaryngology/ Head and Neck Surgey, Oregon Health Sciences University, Portland, Oregon 97201, USA.
Winslow
Catherine P
CP
Andersen
Peter E
PE
D000368:Aged; D003094:Collagen / Q000627:therapeutic use*; D020405:Dermis / Q000503:physiopathology / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D005543:Forearm Injuries / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects*; D017768:Skin, Artificial; D013524:Surgical Flaps / Q000009:adverse effects*; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology; D014950:Wounds, Penetrating / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*
C440568:Alloderm; D003094:Collagen