Abstract
BackgroundRadial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft.MethodsTwenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27–84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated.ResultsAn average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer.ConclusionsDouble-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.
Highlights
Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery
Wester et al suggested that the use of artificial dermis with split-thickness skin grafts (STSG) could have provided thicker coverage of the forearm defect, with minimal donor site morbidity and superior cosmetic results compared with STSG alone [9]
Double-layered collagen graft without STSG represents a viable option for radial forearm donor site reconstruction
Summary
Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. Donor site morbidities have been reported such as poor wound healing, tendon exposure, skin graft failure, and poor esthetic results. The defects of donor site are generally large for primary closure, which needs skin graft for dressing Acceptable managements of such large defects are fullthickness skin graft (FTSG) and split-thickness skin grafts (STSG) [5]. Donor site management with STSG has complications including partial or total necrosis of the skin and poor wound healing. These complications are caused as a result of deficient bulk, and they may lead to restriction of muscle movement, tendon exposure, and widespread wound scarring. The STSGs were harvested from the thigh, and the morbidities include
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
