Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
The Palm Beach Center for Facial Plastic and Laser Surgery, Palm City, Florida, USA.
Otolaryngol Head Neck Surg. 2020 Mar;162(3):277-282. doi: 10.1177/0194599819901124. Epub 2020 Jan 28.
To compare morbidity and aesthetic outcomes of full-thickness skin grafts (FTSGs) and split-thickness skin grafts (STSGs) in the reconstruction of the forearm free flap donor site.
Case series, retrospective chart review.
Institutional microvascular database.
Subjects who underwent forearm free flaps and FTSGs for donor site reconstruction from April 2016 to November 2017 were included. FTSGs were obtained from the donor forearm with a proximal S-shaped incision, thereby avoiding additional wound creation. Morbidity outcomes were compared to 68 consecutive patients with STSG reconstruction from January 2009 to May 2010. Complications, including tendon exposure, subjective functional impairment, complete graft loss, partial graft loss, infection, paresthesias, and hematoma/seroma, were evaluated, as were aesthetic outcomes.
Sixty-eight patients underwent FTSG reconstruction. No significant differences between FTSGs and STSGs were demonstrated in terms of graft loss ≥40% (4% vs 4%, = 1.000), partial graft loss (<40%) (29% vs 40%, = .207), tendon exposure (9% vs 12%, = .573), infection (15% vs 13%, = .805), paresthesias (12% vs 7%, = .382), subjective functional impairment (0% vs 2%, = .316), or hematoma/seroma (2% vs 0%, = .316). Aesthetic outcomes were better in the FTSG group compared to the STSG group, as determined by both patients ( = .004) and surgeon ( < .001).
Our results advocate for the consideration of FTSGs in the reconstruction of the forearm free flap donor site given superior aesthetic results without additional donor site morbidity or additional wound creation when compared to STSGs.
比较全厚皮片（FTSG）和刃厚皮片（STSG）在游离前臂皮瓣供区重建中的发病率和美学效果。
病例系列，回顾性图表分析。
机构微血管数据库。
纳入 2016 年 4 月至 2017 年 11 月期间接受游离前臂皮瓣和 FTSG 供区重建的受试者。FTSG 取自供区前臂的近端 S 形切口，从而避免了额外的创伤。将发病率结果与 2009 年 1 月至 2010 年 5 月期间 68 例连续接受 STSG 重建的患者进行比较。评估了并发症，包括肌腱外露、主观功能障碍、完全皮片丢失、部分皮片丢失、感染、感觉异常和血肿/血清肿，以及美学效果。
68 例患者接受 FTSG 重建。FTSG 和 STSG 在以下方面无显著差异：皮片丢失≥40%（4%与 4%， = 1.000）、部分皮片丢失（<40%）（29%与 40%， =.207）、肌腱外露（9%与 12%， =.573）、感染（15%与 13%， =.805）、感觉异常（12%与 7%， =.382）、主观功能障碍（0%与 2%， =.316）或血肿/血清肿（2%与 0%， =.316）。FTSG 组的美学效果优于 STSG 组，患者（ =.004）和外科医生（ <.001）均如此认为。
与 STSG 相比，FTSG 在游离前臂皮瓣供区重建中具有更好的美学效果，同时不会增加供区发病率或额外的创伤，因此我们支持考虑使用 FTSG。
