Reduction of donor site morbidity in the radial forearm free flap by use of topical tissue expanders.

OBJECTIVE

The objective of this study was to significantly reduce the donor site morbidity associated with use of the radial forearm free flap (RFFF).

DESIGN

A pilot study to test the feasibility of topical tissue expanders to close the RFFF donor site.

SETTING

The setting was a tertiary care teaching hospital.

METHODS

This pilot study consisted of a series of 21 cases that used topical tissue expanders to preoperatively expand the forearm skin. This allowed primary closure of the donor site and, in some cases, closure with a full-thickness skin graft.

MAIN OUTCOME MEASURE

The main outcome measure was the ability to close the RFFF donor site without the use of a partial-thickness skin graft from the lateral thigh. Secondary outcome measures were the postoperative appearance of the donor site wound and function of the forearm.

RESULTS

Twenty-one cases were treated with the preoperative tissue expanders. It was possible to close the donor site without a partial-thickness skin graft from the thigh in 17 of these patients (81%). None of these patients experienced prolonged functional disability or serious complications.

CONCLUSIONS

The use of preoperative topical tissue expanders has the potential to significantly improve donor site morbidity in the RFFF.