Abstract

The vascularized free fibula flap and radial forearm free flap are two workhorse flaps in head and neck reconstruction. This study compared functional and aesthetic outcomes for donor site closure after harvesting radial forearm or fibula free flaps. In a retrospective analysis of 45 patients, three techniques were evaluated: a full-thickness skin graft, a mono-layer Integra® dermal substitute plus a split-thickness skin graft, and a double-layer Integra® with a deferred split-thickness graft. Patient satisfaction scores were significantly higher for the full-thickness graft and the double-layer Integra® technique compared to the mono-layer Integra®. The surgeon’s evaluation found superior aesthetic results for the full-thickness graft over the mono-layer Integra®. Analysis of functional outcomes using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and the Foot and Ankle Disability Index (FADI) score showed no significant differences among the three techniques; however, these functional analyses were exploratory, with DASH available for 34 patients and FADI for only 11, so the absence of significant differences should be interpreted as "no difference detected" rather than as demonstrated equivalence. Therefore, while functional recovery was comparable across these techniques, the full-thickness skin graft provided the most favorable aesthetic result for donor site reconstruction in this cohort.

Keywords

• free tissue flaps
• transplant donor site
• quality of life
• Skin Transplantation;
• Skin, Artificial
• Plastic Surgery Procedures;
• Quality of Life

References

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• Head and Neck Oncology

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