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Figure 1: Design of the combined local triangular full-thickness skin
graft based on 4 skin triangles for rectangular defects Figure 3: Reconstruction of radial forearm free flap donor site defect
with 3 triangles (vertical design)

Figure 4: Partial necrosis of the full-thickness skin graft
Figure 2: Postoperative clinical views of donor site. Horizontal design
with 4 triangles
patients complained of symptoms related to motion or
the donor site was achieved in allcases using the Iberic any other functional deficit. No prolonged hand swelling
graft technique. was found. Assessment ofthe forearm donor site at 1 to
3 months after the primary surgical procedure showed
This technique allows covering big-sized defects using complete defect coverage, good color match, and no
skin grafts extracted from the donor site, obtaining the scarring along the graft line [Figures 5-7].
same color of it. In the series of 125 patients, the RFFF
donor site defects ranged from 15 cm to 70 cm (mean ±
2
2
24.5 cm ). Most patients underwent reconstruction with DISCUSSION
2
4 skin triangles [Figure 2], whereas coverage of the RFFF
donor site with 2 or 3 skin triangles was carried out for Several methods for closure of the RFFF donor site have
smaller defects [Figure 3]. The versatility of this technique been described, most of which are based on theuse of an
[12]
allows using either triangle-shaped or crescent-shaped STSG or an FTSG. Because of its ease in harvesting and
grafts, as convenient for a proper closure. use, the STSG has been the most frequently used method
of reconstruction, although several complications such
Concerning complications of the radial donor site, only as partial skin graft loss, flexor tendon exposure, and
a few patients developed partial necrosis of the FTSG postoperative painand discomfort have been reported.
[9]
[Figure 4] that was treated with local debridement and
healed successfully by secondary intention. No patients The use of FTSG combined with a direct closure of the
developed complete necrosis of the graft. Only two cases FTSG donor site has been reported to provide better
presented tendon exposure. In all cases, these sites pliability and promotion of the healing process, together
healed secondarily by conservative management, with with less postoperative pain and discomfort from the
no final impairment of wrist mobility. No acute ischemia
or compartment syndromes were encountered using this donor site, although it is more time-consuming and
technique. requires additional intraoperative processing of the
graft. [28-31] However, it is used for closure because it
Complete healing typically occurred for 2 to 3 weeks, with provides a thicker base to prevent wound breakdown and
[32]
the longest healing time taking approximately 2 months. a superior esthetic result. This is the main reason for
Although no specific functional tests were applied, no the use of this kind of grafting by the authors.
Plast Aesthet Res || Volume 3 || June 24, 2016 199