Prospective comparison of full thickness and split thickness skin graft for donor site closure of radial forearm flap- First results

Background The radial forearm flap is the most common reconstruction for defects in the head and neck area. For wound closure full (FTSG) or split thickness skin grafts (STSG) are usually used. Recent studies showed them as equivalent.

Methods The prospective study investigates whether one of the grafts is superior regarding aesthetics and complications.

Postoperative photo documentation and patient survey are performed.

Photos are rated by experienced clinicians (n=10) with a validated questionnaire from 1 (as normal skin) to 10 points (worst scar imaginable).

Results A radial forearm flap was used in 16 patients between 08/2020 and 11/2021. Fiveteen patients were included in the study. Nine received a STSG and six a FTSG.

Insufficient tissue integration of the transplant was observes in 3/15 cases. All of them received a FTSG. The negative pressure wound therapy system was deficient in one of these cases.

There were no complications at the full thickness donor site observed.

Prolonged bleeding of the STSG site on the thigh was documented in one patient.

The aesthetical outcome one month after surgery was significantly better regrading all items for STSG. The average rating was 1,0 to 1,3 points less than in the FTSG group.

Discussion Reconstruction the donor site of radial forearm flaps can be achieved by STSG as well as FTSG. In short term observation FTSG showed more disturbances in wound healing and STSGs were rated with a better aesthetic outcome.

Publication History

Article published online:
24 May 2022