title: Full-thickness skin graft from the neck for coverage of the radial forearm free flap donor site.
abstract: OBJECTIVE
  This study describes the use of a full-thickness skin graft (FTSG) from the neck to cover the radial forearm free flap (RFFF) donor site in patients undergoing neck dissection and microvascular reconstruction for ablative head and neck oncologic surgery. The authors propose that an FTSG from the neck provides sufficient tissue quantity and quality, fewer surgical sites, and decreased surgical time and cost compared with other FTSG harvest sites and split-thickness skin grafts (STSGs).
  
  
  METHODS
  This was a retrospective study of 50 patients from 2007 to 2012 who underwent ablative surgery for oral and head and neck cancer with concomitant cervical lymphadenectomy and RFFF reconstruction with repair of the donor site using an FTSG harvested along the neck dissection incision. Patients who underwent donor site repair using other techniques, such as ulnar transposition flaps, were excluded. Medical records and perioperative photographs were reviewed.
  
  
  RESULTS
  Primary closure of the neck without dehiscence was achieved in all cases. There were no recipient site infections. Minor skin graft loss occurred in a minority of patients and was managed with local wound care until healing by secondary intention. No patients required surgical revision of the forearm.
  
  
  CONCLUSIONS
  An FTSG from the neck provides adequate coverage for most RFFF harvests and offers favorable functional and esthetic outcomes. The primary advantage is avoiding a third surgical site. Complications were comparable to those using FTSGs from other harvest sites. Importantly, cross-contamination from the head and neck with the forearm was shown not to be an issue.
authors: Resident, Department of Oral Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL. Electronic address: thanna@uab.edu.
authors: Todd C
authors: TC
authors: Hanna
authors: Resident, Department of Oral Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL.
authors: W Stuart
authors: WS
authors: McKenzie
authors: Adjunct Professor, Department of Oral Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL; Clark Holmes Oral Facial Surgery of Alabama, Birmingham, AL.
authors: Jon D
authors: JD
authors: Holmes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery*; D058752:Free Tissue Flaps / Q000637:transplantation*; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D009333:Neck / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult