Novel design for local full-thickness skin graft: optimizing donor sites of radial forearm free flap.

Abstract

Donor site deformities remain the primary issues after radial forearm free flap (RFFF) translocations. This study introduced a local full-thickness skin graft (FTSG) from an adjacent cutaneous area to manage RFFF donor sites and evaluated the esthetic and functional outcomes post-operatively. This was a retrospective study among patients undergoing ablative surgery for head and neck tumors followed by defect reconstruction using a RFFF. The RFFF donor site defects were covered by local FTSGs from the adjacent skins whose harvesting was assisted by a forearm model or traditional FTSGs from abdomen. The color matching degree, surgical scars, ranges of wrist movement, and grip strengths in donor forearms were assessed in two groups at twelve months after surgery. Patients undergoing local FTSGs recovery exhibited better color matching than those repaired by traditional FTSGs from the abdomen. In forearm model, the local FTSGs width should be less than 22% of the forearm circumference located 5cm away from the center of Fossa cubitalis. All the local FTSGs transplanted with this technique showed primary or secondary healing. This study demonstrated using this innovatively designed local FTSGs to close RFFF donor sites was more advantageous than traditional methods.