Skip to main content
SpringerLink
Log in

Functional and esthetic assessment of radial forearm flap donor site repaired with split thickness skin graft

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the long-term functional and esthetic outcomes of radial forearm flap (RFF) donor site repaired with split thickness skin graft (STSG). Nineteen patients underwent surgical reconstruction of oro-facial defects by the use of RFF and their donor sites were reconstructed with STSG. The patients were followed up at least for 12 months postoperatively and the left hand was the non-dominant hand in all of them. Objective methods including pinch strength, grip strength, range of motion, current perception threshold (CPT) and two-point discrimination, and subjective methods including patients interview, visual analogue score (VAS) about function, sensitivity, pain and color match, were collectively employed for donor site assessment. Our data revealed some degree of reduction in motor function and sensation compared to the non-donor hand. The difference of pinch strength means was 9.81% and of the grip strength was 12.6%. The difference of wrist flexion means was 17.6% and of wrist extension was 13.4%. However, none of the patients had functional defects of forearm supination and pronation, wrist ulnar deviation or wrist radial deviation. Subjective evaluation showed that the donor site repaired with STSG was well accepted by the patients particularly from a functional point of view. These results demonstrate that STSG represents a favorable choice for RFF donor site repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yang G, Chen B, Gao Y (1981) Forearm free skin flap transplantation. Nat Med J China 61:139

    Google Scholar 

  2. Swanson E, Body JB, Manktelow RT (1990) The radial forearm flap: reconstructive applications and donor-site defects in 35 consecutive patients. Plast Reconstr Surg 85(2):258–266

    Article  CAS  PubMed  Google Scholar 

  3. Zuidam JM, Coert JH, Hofer SO (2005) Closure of the donor site of the radial forearm flap, a comparison of full-thickness graft and split thickness skin graft. Ann Plast Surg 55(6):612–616

    Article  CAS  PubMed  Google Scholar 

  4. Ho T, Couch M, Carson K, Schimberg A, Manely K, Byrne PJ (2006) Radial forearm free flap donor site outcomes comparison by closure methods. Otolaryngol Head Neck Surg 134(2):309–315

    Article  PubMed  Google Scholar 

  5. de Witt CA, de Bree R, Verdonck-de Leeuw IM, Quack JJ, Leemans CR (2007) Donor site morbidity of the fasciocutaneous radial forearm flap: what does the patient really bother? Eur Arch Otorhinolaryngol 264(8):929–934

    Article  PubMed  Google Scholar 

  6. Song R, Gao Y, Yu Y, Song Y (1982) The forearm flap. Clin Plast Surg 9(1):21–26

    CAS  PubMed  Google Scholar 

  7. Soutar DS, Scheker LR, Tanner SB, McGregor IA (1983) The radial forearm flap: a versatile method for intra-oral reconstruction. Br J Plast Surg 36(1):1–8

    Article  CAS  PubMed  Google Scholar 

  8. Huang CH, Chen HC, Huang YL, Mardini S, Feng GM (2004) Comparison of the radial forearm flap and the thinned anterolateral thigh cutaneous flap for reconstruction of tongue defects: an evaluation of donor-site morbidity. Plast Reconstr Surg 114(7):1704–1710

    Article  PubMed  Google Scholar 

  9. Valentini V, Cassoni A, Marianetti TM, Battisti A, Terenzi V, Lannetti G (2008) Anterolateral thigh flap for the reconstruction of head and neck defects: alternative or replacement of the radial forearm flap? J Craniofac Surg 19(4):1148–1153

    Article  PubMed  Google Scholar 

  10. Makitie AA, Beasley NJP, Neligan PC, Lipa J, Gullane PJ, Gillbert RW (2003) Head and neck reconstruction with anterolateral thigh flap. Otolaryngol Head Neck Surg 129(5):547–555

    Article  PubMed  Google Scholar 

  11. de Vicente JC, de Villalain L, Torre A, Pena I (2008) Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap. J Oral Maxillofac Surg 66(11):2270–2275

    Article  PubMed  Google Scholar 

  12. Camaioni A, Loreti A, Damiani V, Bellioni M, Passali FM, Viti PC (2008) Anterolateral thigh cutaneous flap vs. radial forearm free-flap in oral and oropharyngeal reconstruction: an analysis of 48 flaps. Acta Otorhinolaryngol Ital 28(1):7–12

    CAS  PubMed  Google Scholar 

  13. Song XM, Ye JH, Yuan Y, Zhang SY, Jiang HB, Wu YN (2010) Radial forearm free flap for reconstruction of a large defect after radical ablation of carcinoma of the tongue and floor of the mouth: some new modifications. ORL Otorhinolaryngol Relat Spec 72(2):106–112

    Google Scholar 

  14. Suominen S, Ahovuo J, Seljavaara SA (1996) Donor site morbidity of radial forearm flaps. Scand J Plast Reconstr Hand Surg 30(1):57–61

    Article  CAS  Google Scholar 

  15. Karimi A, Mahy P, Reychler H (2007) Closure of radial forearm free flap donor site defect with a local meshed full-thickness skin graft; a retrospective study of an original technique. J Craniomaxillofac Surg 35(8):369–373

    PubMed  Google Scholar 

  16. Gupta M, Allen M, Corsten M (2009) Reduction of donor site morbidity in the radial forearm free flap by use of topical tissue expanders. J Otolaryngol Head Neck Surg 38(6):628–631

    PubMed  Google Scholar 

  17. Hurvitz KA, Kobayashi M, Evans GR (2006) Current options in head and neck reconstruction. Plast Reconstr Surg 118(5):122e–133e

    Article  PubMed  Google Scholar 

  18. Timmons MJ, Missotten FEM, Poole MD, Davies DM (1986) Complications of radial forearm flap donor sites. Br J Plast Surg 39(2):176–178

    Article  CAS  PubMed  Google Scholar 

  19. Chen CM, Lin GT, Fu YC, Shieh TY, Huang IY, Shen YS, Chen CH (2005) Complications of free radial forearm flap transfers for head and neck reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99(6):671–676

    Article  PubMed  Google Scholar 

  20. Emerick KS, Deschler DG (2007) Incidence of donor site skin graft loss requiring surgical intervention with the radial forearm free flap. Head Neck 29(6):573–576

    Article  PubMed  Google Scholar 

  21. Brown MT, Couch ME, Huchton DM (1999) Assessment of donor-site functional morbidity from radial forearm fasciocutaneous free flap harvest. Arch Otolaryngol Head Neck Surg 125(12):1371–1374

    CAS  PubMed  Google Scholar 

  22. Harkonen R, Piirtomaa M, Alaranta H (1993) Grip strength and hand position of the dynanometer in 204 Finnish adults. J Hand Surg 18(1):129–132

    CAS  Google Scholar 

  23. Bassey EJ, Harries UJ (1993) Normal values for hand-grip strength in 920 men and women aged over 65 years, and logitudinal changes over 4 years in 620 survivors. Clin Sci 84(3):331–337

    CAS  PubMed  Google Scholar 

  24. Skoner JM, Bascom DA, Cohen JI, Andersen PE, Wax MK (2003) Short-term functional donor site morbidity after radial forearm fasciocutaneous free flap harvest. Laryngoscope 113(12):2091–2094

    Article  PubMed  Google Scholar 

  25. Boorman JG, Brown JA, Sykes PJ (1987) Morbidity in the forearm flap donor arm. Br J Plast Surg 40(2):207–212

    Article  CAS  PubMed  Google Scholar 

  26. Brown MT, Cheny ML, Gliklich RL, Sheffler LR, Varvares MA (1996) Assessment of functional morbidity in the radial forearm free flap donor site. Arch Otolaryngol Head Neck Surg 122(9):991–994

    CAS  PubMed  Google Scholar 

  27. Kerawala CJ, Martin IC (2006) Sensory deficit in the donor hand after harvest of radial forearm free flaps. Br J Oral Maxillofac Surg 44(2):100–102

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Seoul Research & Business Development Program (10548).

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 275-1, Yeongeon-Dong, Jongno-Gu, Seoul, 110-768, Republic of Korea

    Jong-Ho Lee, Mohammad S. Alrashdan, Su-Gon Kim, Myung-Jin Kim & Soung-Min Kim

  2. Department of Dentistry and Oral Surgery, Kuro Hospital, Korea University, Seoul, Republic of Korea

    Jae-Seok Rim

  3. Division of Plastic and Reconstructive Surgery, Department of Surgery, Jordan University Hospital, Amman, Jordan

    Samir Jabaiti

Authors
  1. Jong-Ho Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad S. Alrashdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Su-Gon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae-Seok Rim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Samir Jabaiti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Myung-Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Soung-Min Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Soung-Min Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, JH., Alrashdan, M.S., Kim, SG. et al. Functional and esthetic assessment of radial forearm flap donor site repaired with split thickness skin graft. Eur Arch Otorhinolaryngol 268, 109–115 (2011). https://doi.org/10.1007/s00405-010-1314-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-010-1314-z

Keywords

Search

Navigation