The reliability of the “Iberic graft” for covering of the radial forearm free flap donor site

Abstract

Aim: Traditional donor site closure from radial forearm free flap (RFFF) has been associated with esthetic and functional morbidity. To avoid complications, such as color mismatch and secondary donor site morbidity, a new technique named ‘‘Iberic graft’’ for covering the RFFF donor site was described previously by our team.

Methods: A study of patients who underwent reconstruction of head and neck defects using a RFFF was conducted to assess postoperative complications of the RFFF donor site and also to evaluate the morbidity in terms of aesthetics and function following the use of the “Iberic graft”. The donor site was covered by the use of a combined local triangular full-thickness skin graft. Color match, quality of the scar, presence of necrosis, dehiscence of the suture or tendon exposure were recorded and analyzed.

Results: One hundred and twenty-five consecutive patients undergoing RFFF harvesting were included. RFFF donor site defects ranged from 15 cm² to 70 cm²; 9 patients (7%) had small dehiscences of the forearm skin graft, whereas 2 cases (1.6%) presented tendon exposure. Otherwise, partial skin graft loss occurred in a few patients. In all cases, these sites healed secondarily by conservative management, with no final impairment of function. Assessment of the forearm donor site at 1 to 3 months after the primary surgical procedure showed complete defect coverage, good color match, and no scarring along the graft line.

Conclusion: The “Iberic graft” is a reliable method for closing most of RFFF donor site defects as it provides excellent color match and pliability, while obviates the need for a second surgical site.

Keywords

Radial forearm free flap / donor site morbidity / full-thickness skin graft / “Iberic graft”

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