Incidence of donor site skin graft loss requiring surgical intervention with the radial forearm free flap

Background. Many methods of managing the fasciocutaneous radial forearm free flap (RFFF) donor site have been described. Ideal management would be technically easy to perform, reliable, cost-effective, and prevent further complications. Methods. The clinical records of 54 consecutive patients undergoing RFFF surgery by the senior author were reviewed. Records were reviewed to identify donor sites with significant breakdown that required intervention. Results. Fifty-four patients were identified. Only 1 patient had significant tendon exposure. A V to Y closure was performed. The site healed well following this procedure and no further intervention was required. No other donor site complications were noted in this group. Conclusion. The incidence of wound breakdown requiring surgical intervention at the RFFF donor site is less than 2% utilizing a simple technique of split thickness skin grafting, bolster, and short-term splinting. This study demonstrates the low donor site morbidity of the RFFF. (c) 2007 Wiley Periodicals, Inc.