Comparison between primary closure and skin grafts of the free fibula osteocutaneous flap donor site.
OBJECTIVE
This study aimed to compare the size of skin paddles, the postoperative course, and donor site complications between primary closure and skin grafts of the free fibula flap donor site.


METHODS
Thirty-five consecutive patients were enrolled. Medical records were retrospectively reviewed for risk factors for delayed healing, size of skin paddles, time to resumption of gait with a mobility aid and self-ambulation, early donor site morbidity, and late donor site complaints.


RESULTS
The harvested skin paddles were significantly wider in the skin graft group than in the primary closure group (P = 0.02), with no difference in length (P = 0.1). The difference in time to resuming gait with a mobility aid was also significant (P = 0.01), but not the time to self-ambulation (P = 0.9). Two early donor site morbidities (5.7 %) and 12 late donor site complaints (34.3 %) were found. No significant difference in the incidence of early donor site morbidity was observed between two groups. Occurrence of late donor site complaints was not affected by any risk factors.


CONCLUSIONS
The width of the harvested skin paddle, but not the length, is one of factors involved in donor site closure. Resumption of gait with a mobility aid, but not self-ambulation, may be delayed in skin graft patients.
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan. akashim@med.kobe-u.ac.jp.
Masaya
M
Akashi
Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Kazunobu
K
Hashikawa
Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Hiroyuki
H
Takasu
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Kazuhiro
K
Watanabe
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Junya
J
Kusumoto
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Akiko
A
Sakakibara
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Takumi
T
Hasegawa
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Tsutomu
T
Minamikawa
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 650-0017, Japan.
Takahide
T
Komori
D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013515:Surgery, Oral / Q000379:methods*; D060053:Transplant Donor Site / Q000601:surgery*; D058106:Wound Closure Techniques
Donor site morbidity; Free fibula osteocutaneous flap; Primary closure; Skin graft