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.