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Pursestring Closure of Radial Forearm Fasciocutaneous Donor Sites
Author(s) -
Winslow Catherine P.,
Hansen Juliana,
Mackenzie Doug,
Cohen James I.,
Wax Mark K.
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200011000-00009
Subject(s) - cosmesis , medicine , forearm , surgery
Background The radial forearm fasciocutaneous free flap has become one of the most common methods of reconstructing defects after head and neck ablative surgery. The fasciocutaneous flap is an excellent replacement for the tissue that has been removed. Unfortunately, donor site morbidity remains a problem. Donor site morbidity is primarily related to poor skin graft take, cosmesis, and neural dysfunction. Decreasing the size of the donor site defect may allow for improved cosmesis with decreased morbidity. Material and Methods Prospective evaluation of a pursestring closure of radial forearm fasciocutaneous donor sites over a 16‐month period. Results Seventy‐one radial forearm free flaps were used. Sixty‐seven had a pursestring closure of the donor site. After flap elevation the mean size of the defect was 61 cm 2 (range, 28–140 cm 2 ). Pursestring closure decreased the mean of the defect to 34 cm 2 (range, 10–104 cm 2 ) ( P <.0001). Defect size was decreased by a mean of 44.5% (range, 24.5%–66.7%) ( P <.0001). Complications The rate of skin graft loss (>25%) (9% of patients) was less than that reported in the literature. No patient required a second surgical procedure. Neural morbidity was equal in both groups. Cosmesis was much improved. Conclusions Pursestring closure allowed for a significantly decreased donor defect, associated with better cosmesis and less skin graft loss.