title: Removal of the split thickness skin graft from the skin paddle of the donor site: A single institution's experience.
abstract: OBJECTIVE
  Radial forearm free flaps (RFFFs) and fibular osteocutaneous flaps (FOFs) are mainstays of head and neck reconstruction. Removal of the donor tissue often leaves a soft tissue defect requiring a split thickness skin graft (STSG) for coverage. The purpose of this study is to evaluate the potential to reduce the morbidity of removal of the STSG from a second site.
  
  
  METHODS
  We report a series of 9 patients who had the STSG taken from the free flap donor skin paddle as an alternative to removal from the standard distant sight.
  
  
  RESULTS
  9/9 (100%) flaps were successfully transferred with no primary or secondary loss of the flap. 8/9 (89%) of STSGs were successfully harvested from the donor skin paddle. Postoperative complications included infection and partial STSG loss (2/9, 22%).
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and reduced morbidity associated with removal of the STSG from the donor flap skin paddle in addition to the placement of a de-epithelialized free flap in head and neck reconstruction patients. Given this research, which supports the previously published research on this topic, this technique could be considered in an effort to reduce morbidity in patients undergoing head and neck reconstruction using the RFFF and FOF.
authors.affiliation: Mayo Clinic, Department of Otolaryngology, 200 1st Street SW, Rochester, MN, USA. Electronic address: olson.michael@mayo.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Olson
authors.affiliation: Mayo Clinic, Department of Otolaryngology, 200 1st Street SW, Rochester, MN, USA. Electronic address: moore.eric@mayo.edu.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.affiliation: Mayo Clinic, Department of Otolaryngology, 200 1st Street SW, Rochester, MN, USA. Electronic address: price.daniel@mayo.edu.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Price
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005360:Fibula / Q000601:surgery; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000637:transplantation*; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D060053:Transplant Donor Site; D055815:Young Adult