Avoiding Secondary Skin Graft Donor Site Morbidity in the Fibula Free Flap Harvest

Abstract

To compare donor site morbidity in patients who have undergone fibula free flap reconstruction in which the skin graft was taken from the expected cutaneous paddle of the fibula with the known complications of the popular technique of obtaining a split-thickness skin graft (STSG) from a secondary donor site.

Comparing the Outcomes of Osteocutaneous Radial Forearm and Fibula Free Flaps in the Reconstruction of Mandibular Osteoradionecrosis

“…A common concern with the OC‐RFFF donor site is the risk of radius fracture (Zenn et al 1997; Vaughan 1990; Richardson et al 1997). In this study, all OC‐RFFF donor sites underwent prophylactic plating, and we experienced one radius fracture (2.1%), consistent with prior published studies (Day et al 2014; Ho et al 2013; Kim et al 2008). Bowers et al (2000) reported on prophylactically plating the distal radius, with multiple other studies confirming the safety of this method (Arganbright et al 2013; Shnayder et al 2011).…”

“…Complication rates related to the FFF donor site are reported to be high (Ho et al 2013). Kim et al (2008) reported an STSG loss of 13% in their FFF donor sites, which is lower than our reported patients. In their study, they harvested the graft from the donor site skin paddle.…”

Reconstructing Severe Lower Extremity Skin Necrosis in a Pediatric Patient

“…8 However, the latter can be used for the maturation and contraction of large wounds to reduce the amount of autograft required for final coverage. 9 In this case patient, TheraSkin was used as a temporizing measure but was also found to reduce the amount of required skin graft by nearly 70%. The soleus flap used to conceal the tibia is visible prior to TheraSkin use.…”

“…In wound reconstruction, split-thickness skin autografts provide optimal viability and tissue development compared with cellular and/or tissue-based products 8 . However, the latter can be used for the maturation and contraction of large wounds to reduce the amount of autograft required for final coverage 9 . In this case patient, TheraSkin was used as a temporizing measure but was also found to reduce the amount of required skin graft by nearly 70%.…”

Improving Aesthetic Outcomes in Pediatric Free Tissue Oromandibular Reconstruction

“…Because the success rates have remained high in experienced hands, there has to be an evolution in tailoring these flaps in such a way as to minimize both recipient and donor site issues. This has been the trend over the past few years 7,8…”