Full-Thickness Skin Grafts for Coverage of the Pedicle in Partial Second Toe Pulp Free Flap

Pedicle coverage during free flap reconstruction of the digit commonly presents complicated issues. As the finger is a cylindrical unit with small volume, it is difficult to secure ample soft tissue for relaxed coverage of the pedicle. We have applied full-thickness skin grafts (FTSGs) to loosely cover the pedicle of the free flap of the fingertip and report preliminary results. Seven patients who received free toe pulp flap and FTSG for soft tissue coverage of the pedicle were analyzed. Intraoperative parameters collected were defect, flap and graft area size and donor site. Patients were observed postoperatively for up to 2 months for graft take, necrosis, digit contour, and donor site complications. The average area of the free flap was 2.39±1.03 cm<sup>2</sup> and the average graft area was 1.37±1.06 cm<sup>2</sup>. The FTSG survived without sloughing or necrosis in six patients. Early epithelial sloughing with dermis take was noted in one patient who healed with dressings. The pedicle and graft portion showed bulging immediately after the operation but decreased to normal contour by 4 weeks. FTSG is an option that can be safely used as a method of pedicle coverage during free flap reconstruction of digits.

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Full-Thickness Skin Graft as a One-Stage Debulking Procedure after Free Flap Reconstruction for the Lower Leg

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000261090.58038.13 ◽

2007 ◽

Vol 119 (7) ◽

pp. 2330 ◽

Cited By ~ 1

Author(s):

Ramesh Kumar Sharma ◽

Puneet Tuli ◽

Surinder Singh Makkar

Keyword(s):

Skin Graft ◽

Free Flap ◽

Lower Leg ◽

Full Thickness ◽

Flap Reconstruction ◽

Free Flap Reconstruction ◽

Full Thickness Skin Graft ◽

Full Thickness Skin ◽

One Stage ◽

Thickness Skin

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Reconstructing Forearm Free Flap Donor Sites Using Full-Thickness Skin Grafts Harvested from the Ipsilateral Arm

Otolaryngology ◽

10.1177/0194599819901124 ◽

2020 ◽

Vol 162 (3) ◽

pp. 277-282

Author(s):

Natalie A. Krane ◽

Alia Mowery ◽

James Azzi ◽

Daniel Petrisor ◽

Mark K. Wax

Keyword(s):

Free Flap ◽

Functional Impairment ◽

Donor Site ◽

Graft Loss ◽

Case Series ◽

Retrospective Chart Review ◽

Skin Grafts ◽

Full Thickness ◽

Full Thickness Skin ◽

Thickness Skin

Objective To compare morbidity and aesthetic outcomes of full-thickness skin grafts (FTSGs) and split-thickness skin grafts (STSGs) in the reconstruction of the forearm free flap donor site. Study Design Case series, retrospective chart review. Setting Institutional microvascular database. Subjects and Methods Subjects who underwent forearm free flaps and FTSGs for donor site reconstruction from April 2016 to November 2017 were included. FTSGs were obtained from the donor forearm with a proximal S-shaped incision, thereby avoiding additional wound creation. Morbidity outcomes were compared to 68 consecutive patients with STSG reconstruction from January 2009 to May 2010. Complications, including tendon exposure, subjective functional impairment, complete graft loss, partial graft loss, infection, paresthesias, and hematoma/seroma, were evaluated, as were aesthetic outcomes. Results Sixty-eight patients underwent FTSG reconstruction. No significant differences between FTSGs and STSGs were demonstrated in terms of graft loss ≥40% (4% vs 4%, P = 1.000), partial graft loss (<40%) (29% vs 40%, P = .207), tendon exposure (9% vs 12%, P = .573), infection (15% vs 13%, P = .805), paresthesias (12% vs 7%, P = .382), subjective functional impairment (0% vs 2%, P = .316), or hematoma/seroma (2% vs 0%, P = .316). Aesthetic outcomes were better in the FTSG group compared to the STSG group, as determined by both patients ( P = .004) and surgeon ( P < .001). Conclusions Our results advocate for the consideration of FTSGs in the reconstruction of the forearm free flap donor site given superior aesthetic results without additional donor site morbidity or additional wound creation when compared to STSGs.

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