Full-thickness skin graft from the groin for coverage of the radial forearm free flap donor site

University of California, San Francisco, San Francisco, California, United States
American Journal of Otolaryngology (Impact Factor: 0.98). 09/2007; 28(5):325-9. DOI: 10.1016/j.amjoto.2006.10.009
Source: PubMed

ABSTRACT The purpose of this study is to describe the use of a full-thickness skin graft from the groin for coverage of the radial forearm free flap donor site. Our hypothesis is that the use of the full-thickness skin graft decreases morbidity and improves functional and cosmetic outcome at the skin graft donor site while also providing excellent coverage of the forearm donor site.
This study used a retrospective chart review design.
Patients undergoing radial forearm free flap reconstructions from 1995 to 2005 were included. Forty patients underwent radial forearm free flap reconstruction with closure of the forearm donor site with a full-thickness skin graft harvested from the groin. The inguinal donor site was closed primarily. Medical records including clinic notes, operative reports, and photographs were reviewed.
There was 1 minor wound dehiscence at the groin site, and there were 5 minor forearm wound dehiscences with 2 cases of tendon exposure; all dehiscences were treated conservatively with local wound care. Both the groin wound and forearm donor sites healed satisfactorily in all cases, with no impairment of function related to the skin graft. All patients expressed satisfaction with the postoperative pain, functional outcome, and cosmetic appearance related to both the skin graft and forearm donor sites.
Full-thickness skin graft from the groin for coverage of the radial forearm free flap donor site is an effective, safe alternative to the traditional split thickness skin graft.

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    • "Likewise, STSG requires much more effort in terms of postoperative care of the donor site3. FTSG offers the advantages of superb esthetics4, less postoperative shrinkage, and minimal postoperative pain and scar formation through primary closure compared to STSG5,6. Nonetheless, the size of FTSG is relatively limited, and there is a possibility of graft failure due to the thickness of the graft7. "
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    ABSTRACT: Full thickness skin grafts (FTSG) offer several advantages; they are esthetically superb, have less postoperative shrinkage, and offer minimal postoperative pain and scar formation at the donor site. As a donor site of FTSG, the groin offers a relatively large area of skin with high elasticity. The aim of this study was to evaluate FTSG from the groin for reconstruction in oral and maxillofacial surgery. In a retrospective study, 50 patients (27 males, 23 females) who received FTSG from the groin were evaluated for their operation records, clinical photography, and medical records. The width of skin from the groin was distributed from 2-8 cm (mean: 5.1 cm) at the donor site, while the long axis length was distributed from 3-13 cm (mean: 7.4 cm). A high number of patients, 47 patients (94%) out of 50, showed good healing at the donor site. Wound impairment was seen in 3 patients (6%), minor wound dehiscence in 2 patients, and severe wound dehiscence in 1 patient. In the recipient site, delayed healing was observed in 2 patients (4%). FTSG from the groin to repair soft tissue defects in reconstruction surgery is a good method due to the relatively big size of the graft, decreasing morbidity at the donor site, and higher graft survival rates.
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    ABSTRACT: The free radial forearm flap is an excellent method for reconstruction of defects in the head and neck region. In the literature, there is still disagreement about the best surgical treatment of the forearm defect to avoid functional and cosmetic drawbacks. There is a debate about using full-thickness skin graft or better split thickness skin graft. To evaluate our own results after radial forearm flap surgery, a follow-up examination and standardized interview of 25 patients was performed. For closure of the donor site, a full skin graft from the groin was used in 17 cases and split skin graft from the thigh in eight cases. All patients were satisfied with postoperative results and hand function for everyday use. Subjective complaints were more common in the split skin graft group, especially related to loss of sensibility. Because of severe wound healing failure with tendon exposure in one case after split skin grafting, there was the necessity for surgical revision. During the medical examination, we documented more functional impairments in the split skin graft group than in patients after full skin grafting. Only the development of hypertrophic scars dominated in the full skin graft group. According to the trend to fewer complications, we prefer full-thickness skin grafts for the closure of the donor site after radial forearm flap surgery.
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