Closure of the Radial Forearm Free Flap Donor Site Using the Combined Local Triangular Full-Thickness Skin Graft.
OBJECTIVE
Traditional donor-site closure has been associated with serious esthetic and functional morbidity. The purpose of this study was to assess morbidity in esthetics and function and measure the postoperative complications of the radial forearm free flap (RFFF) donor site after using combined local triangular full-thickness skin grafting.


METHODS
This prospective study of patients who underwent reconstruction of head and neck defects using an RFFF was conducted from July 2008 through December 2014. The donor site was repaired with a combined local triangular full-thickness skin graft. Quality of the scar, color match, tendon exposure, presence of necrosis, dehiscence of the suture, and presence of dysesthesia were recorded and analyzed using SPSS 21.0 software.


RESULTS
One hundred consecutive patients (71 male and 29 female) underwent RFFF harvesting. RFFF donor-site defects ranged from 15 to 70 cm2; partial skin graft loss occurred in 7% of patients. Five patients (5%) had small dehiscences of the forearm skin graft, and 2 cases (2%) presented tendon exposure. In all cases, these sites healed secondarily by conservative management, with no final impairment of function. Esthetic results were considered excellent in 87%, good in 11%, and suboptimal in 2% of the cases.


CONCLUSIONS
The combined local triangular full-thickness skin graft is a reliable method for closing RFFF donor-site defects because it obviates a second surgical site, it provides excellent color match and pliability, and it can be used for covering large defects of the donor site.
Resident Surgeon, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain. Electronic address: manumorenosanchez@hotmail.com.
Manuel
M
Moreno-Sánchez
Consultant Surgeon, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain; International Member, American Society of Temporomandibular Joint Surgeons, Mound, MN.
Raúl
R
González-García
Consultant Surgeon, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain.
Luis
L
Ruiz-Laza
Consultant Surgeon, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain.
Damián
D
Manzano Solo de Zaldívar
Consultant Surgeon, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain.
Carlos
C
Moreno-García
Head, Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain; International Member, American Society of Temporomandibular Joint Surgeons, Mound, MN.
Florencio
F
Monje
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods*; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery*; D058752:Free Tissue Flaps / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D011884:Radius / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012880:Skin Pigmentation / Q000502:physiology; D016038:Skin Transplantation / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013710:Tendons / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery*; D016896:Treatment Outcome