Prospective study of the septocutaneous radial free flap and suprafascial donor site

This is a prospective study of 121 consecutive radial septocutaneous flaps harvested by one surgeon. There were 117 successful flaps (97%). The incidence of early return to theatre for potential problems with the flap or the neck wound was 12/121 (10%) and the flap salvage rate was 3/7 (43%). The incidence of three early wound healing complications at the suprafascial donor site were: loss of the skin graft (4%), tendon exposure (3%) and delayed healing (4%). A full-thickness skin graft, usually from the inner upper arm, was used to repair three-quarters of donor site defects. The median time to healing was significantly longer for partial thickness grafts (14 days compared with 10 days, p < 0.001). The degree of contraction of the skin graft used to repair the radial defect was significantly less for full thickness than partial thickness grafts (median -21% compared with -33%, p = 0.01). There was more relative contraction with larger grafts (p < 0.00 1) and in older patients (p = 0.01). The septocutaneous radial flap is reliable. The early morbidity at the suprafascial donor site is relatively low in comparison to that reported at the subfascial donor site. (C) 2007 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.