J Reconstr Microsurg 2005; 21(2): 113-117
DOI: 10.1055/s-2005-864844
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of the Donor Site in Patients who Underwent Reconstruction with a Free Radial Forearm Flap

Osamu Ito1 , Hiroharu H. Igawa2 , Shigehiko Suzuki3 , Gan Muneuchi2 , Takeshi Kawazoe3 , Yasumi Saso3 , Masayuki Onodera2 , Susam Park2 , Yuiro Hata4
  • 1Departments of Plastic and Reconstructive Surgery, Kagawa Prefectural Central Hospital kagawa, Japan
  • 2Kagawa University kagawa, Japan
  • 3Kyoto University, Japan
  • 4Tokyo Medical and Dental University, Japan
Further Information

Publication History

Accepted: September 23, 2004

Publication Date:
28 February 2005 (online)

ABSTRACT

A major disadvantage of free radial forearm flaps is the conspicuous donor site. However, there have been few studies on donor scars. The authors evaluated the donor site in patients who underwent oral-floor reconstruction with a free radial forearm flap. The subjects were 23 patients (19 males and four females) who underwent reconstruction with a free radial forearm flap following resection of a malignant oral tumor, and were followed for 1 year or longer. The fasciocutaneous flap collection site was closed by full-thickness skin graft (FTSG) from the groin with tie-over dressing. All grafts took perfectly. At the scar at the donor site, five items (pigmentation, scar width, depression, wrist mobility, and sensory abnormalities) were evaluated. Depression and pigmentation were often observed, but patient dissatisfaction was slight. While their main postoperative concern was the oral reconstruction site, after about 1 year, the donor site became more important to patients. However, the results were good. A 100 percent take of the FTSG at the donor site should produce good results. Surgeons should pay adequate attention not only to the outcome at the reconstruction site, but also to the closure of the donor site.

REFERENCES

  • 1 Soutar D S, Scheker L R, Tanner N SB et al.. The radial forearm flap: a versatile method for intra-oral reconstruction.  Br J Plast Surg. 1983;  36 1-5
  • 2 Fenton O M, Robert J O. Improving the donor site of the radial forearm flap.  Br J Plast Surg. 1985;  38 504-505
  • 3 Timmons M J, Missotten F EM, Poole M D et al.. Complications of radial forearm flap donor sites.  Br J Plast Surg. 1986;  39 176-178
  • 4 MaGregor A D. The free radial forearm flap - the management of the secondary defect.  Br J Plast Surg. 1987;  40 83-85
  • 5 Gaukroger M C, Langdon J D, Whear N M et al.. Repair of the radial forearm flap donor site with a full-thickness graft.  Int J Oral Maxillofac Surg. 1994;  23 205-208
  • 6 Liang M D, Swartz W M, Jones N F. Local full-thickness skin-graft coverage for the radial forearm flap donor site.  Plast Reconstr Surg. 1994;  93 621-624
  • 7 Lutz B S, Wei F-C, Chang S CN et al.. Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases.  Plast Reconstr Surg. 1999;  103 132-137
  • 8 Bardsley A F, Souter D S, Elliot D et al.. Reducing morbidity in the radial forearm flap donor site.  Plast Reconstr Surg. 1990;  86 287-292
  • 9 Richardson D, Fisher S E, Vaughan E D et al.. Radial forearm flap donor-site complications and morbidity: a prospective study.  Plast Reconstr Surg. 1997;  99 109-115
  • 10 Boorman J G, Brown J A, Sykes P J. Morbidity in the forearm flap donor arm.  Br J Plast Surg. 1987;  40 207-212
  • 11 Samis A JW, Davidson J SD. Skin-stretching device for intraoperative primary closure of radial forearm flap donor site.  Plast Reconstr Surg. 2000;  105 698-702
  • 12 Elliot D, Bardsley A F, Batchelor A G et al.. Direct closure of the radial forearm flap donor defect.  Br J Plast Surg. 1988;  41 358-360
  • 13 Hallock G G. Refinement of the radial forearm flap donor site using skin expansion.  Plast Reconstr Surg. 1988;  81 21-25
  • 14 Wax M K, Winslow C P, Andersen P E. Use of allogenic lermis for radial forearm free flap donor site coverage.  J Otolaryngol. 2002;  31 341-345
  • 15 Moazzam A, Gordon D J. Cross-suturing as an aid to wound closure: a prospective randomized trial using the forearm flap donor as a model.  Br J Plast Surg. 2003;  56 695-700

Osamu ItoM.D. 

Department of Plastic and Reconstructive Surgery, Kagawa University

1750-1, Ikenobe, Miki-cho, Kita-gun

Kagawa 761-0793, Japan