title: Stabilizing Morbidity and Predicting the Aesthetic Results of Radial Forearm Free Flap Donor Sites.
abstract: BACKGROUND
  The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap.
  
  
  METHODS
  In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance.
  
  
  RESULTS
  Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars.
  
  
  CONCLUSIONS
  Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Tae Kyoung
authors.initials: TK
authors.lastname: Yun
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eul Sik
authors.initials: ES
authors.lastname: Yoon
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Duck Sun
authors.initials: DS
authors.lastname: Ahn
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Byung Il
authors.initials: BI
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyon Surk
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hi Jin
authors.initials: HJ
authors.lastname: You
keywords: Aesthetics; Cicatrix; Free tissue flaps; Morbidity; Skin transplantation