An Ideal Choice for Closure of Large Free Radial Forearm Flap Donor Site Using a Local Full-Thickness Skin Graft

The local full-thickness skin graft (FTSG) method based on the V-Y closure is reported to be the most convenient and reliable technique for free radial forearm flap (FRFF) donor site closure. The spindle-shaped FTSG was the most common local closure method in free osteofasciocutaneous fibula flaps but not FRFF reconstructions, despite being conveniently applicable to FRFF donor sites. The authors devised a spindle-shaped FTSG harvested from the ipsilateral radial forearm as a new concept in repairing the FRFF donor site. This procedure was performed on 4 patients and the average flap defect size was 5.0 x 8.3 cm (41.3 cm(2)). The spindle-shaped FTSG is more likely to adapt to longer FRFFs, while a V-Y closure is more likely to adapt to wider ones. It is desirable to use both FTSGs properly depending on the large FRFF shape.