Removal of the split thickness skin graft from the skin paddle of the donor site: A single institution’s experience

Abstract Purpose Radial forearm free flaps (RFFFs) and fibular osteocutaneous flaps (FOFs) are mainstays of head and neck reconstruction. Removal of the donor tissue often leaves a soft tissue defect requiring a split thickness skin graft (STSG) for coverage. The purpose of this study is to evaluate the potential to reduce the morbidity of removal of the STSG from a second site. Materials and methods We report a series of 9 patients who had the STSG taken from the free flap donor skin paddle as an alternative to removal from the standard distant sight. Results 9/9 (100%) flaps were successfully transferred with no primary or secondary loss of the flap. 8/9 (89%) of STSGs were successfully harvested from the donor skin paddle. Postoperative complications included infection and partial STSG loss (2/9, 22%). Conclusions This study demonstrates the feasibility and reduced morbidity associated with removal of the STSG from the donor flap skin paddle in addition to the placement of a de-epithelialized free flap in head and neck reconstruction patients. Given this research, which supports the previously published research on this topic, this technique could be considered in an effort to reduce morbidity in patients undergoing head and neck reconstruction using the RFFF and FOF.