Limiting donor site morbidity by suprafascial dissection of the radial forearm flap

Abstract

A technique of suprafascial flap elevation to prevent donor site problems is described, based on careful intraoperative observation of the anatomical relations of all involved structures in a series of over 400 free forearm flaps used in various reconstructive procedures.

Radial Forearm Free Flap Donor Site Outcomes Comparison by Closure Methods

“…Another of our hypotheses was that functional outcome should not differ significantly among the 3 groups because the harvesting techniques for the RFFF are standardized for all 3 treatment groups and spare the major nerves. 7,9 Indeed, in this study, we find comparable subjective and objective outcomes among the 3 groups. The exceptions included the significant reduction in range of wrist flexion and ulnar deviation seen in patients reconstructed with FTSG compared with the other 2 groups.…”

“…Another of our hypotheses was that functional outcome should not differ significantly among the 3 groups because the harvesting techniques for the RFFF are standardized for all 3 treatment groups and spare the major nerves 7,9 . Indeed, in this study, we find comparable subjective and objective outcomes among the 3 groups.…”

Donor Site Wound Healing in Radial Forearm Flap

“…Subfascial dissection without paratenon impairment provides a favorable wound bed suitable for a primary STSG reconstruction, but the chance of providing a gliding surface for a functional tendon without adhesions is low. Suprafascial dissection markedly reduced wound healing problems but is technically more demanding and provides a less bulky flap 12,26 . In our experience, FTSG is the most appropriate autologous skin graft procedure pondering wound healing and functional outcomes.…”

“…Suprafascial dissection markedly reduced wound healing problems but is technically more demanding and provides a less bulky flap. 12,26 In our experience, FTSG is the most appropriate autologous skin graft procedure pondering wound healing and functional outcomes. Nevertheless, consistent limitations including defect size, more difficult graft uptake, and donor site morbidity cannot be neglected.…”

Suprafascial Free Flaps: Classification and Comprehensive Review of the Literature

“…13 In radial flaps, suprafascial dissection has shown to decrease tendon exposure and improved healing of skin grafts. [14][15][16][17] Fibula flaps dissected in the suprafascial plane have also shown lower donor site morbidity and better wound contour. 18 Thin flaps (dissected in the superficial adipose fascia) have also shown to improve donor site aesthetics due to a more uniform wound contour and higher primary closure rate.…”