Our Summary

This research paper focuses on a procedure known as the radial forearm free flap (RFFF), which is a commonly used method for various types of reconstructive surgery. After this procedure, the area from where the flap was taken (the donor site) needs to be closed, typically using either a full-thickness skin graft (FTSG) or a split-thickness skin graft (STSG).

However, this closure can lead to complications and may affect the function and appearance of the forearm and hand. This study aims to compare the outcomes related to wounds, function, and aesthetics when using FTSG versus STSG for the closure of the donor site after an RFFF procedure.

To do this, the researchers will carry out a systematic review and meta-analysis, following the PRISMA guidelines. They will search several databases for relevant studies up until January 15, 2024, and recheck the search 12 months before publishing the review.

The studies included will be those that report on complications at the donor site following an RFFF and closure of the defect using either FTSG or STSG. Studies that don’t have a control group, animal studies, and studies on cadavers will be excluded.

Two reviewers will assess each study in a blinded review, with a third reviewer resolving any discrepancies. The researchers will use specific tools to assess the risk of bias in the original studies, and will use Review Manager software to synthesize the data.

The results of this study could help us understand the rates of complications with both closure techniques and could be important for developing future guidelines for managing the donor site after an RFFF procedure. If the available data is limited and leaves several questions unanswered, more comparative studies will be needed. The study protocol was registered with the International Prospective Register of Systematic Reviews on September 17, 2023.

FAQs

  1. What is the radial forearm free flap (RFFF) procedure and why is it used?
  2. What are the differences between a full-thickness skin graft (FTSG) and a split-thickness skin graft (STSG)?
  3. What is the goal of this research study and how will it be conducted?

Doctor’s Tip

One tip a doctor might give a patient about skin graft surgery is to follow post-operative care instructions carefully to promote proper healing and reduce the risk of complications. This may include keeping the area clean and dry, avoiding excessive movement or pressure on the graft site, and taking any prescribed medications as directed. Additionally, attending follow-up appointments with your healthcare provider is crucial for monitoring your healing progress and addressing any concerns promptly.

Suitable For

Patients who undergo skin graft surgery typically have conditions or injuries that have resulted in significant skin loss or damage. Some common types of patients who may be recommended for skin graft surgery include:

  1. Burn victims: Skin graft surgery is often used to treat severe burns by replacing damaged skin with healthy skin from another part of the body.

  2. Trauma patients: Patients who have suffered traumatic injuries, such as deep lacerations or crush injuries, may require skin graft surgery to repair the damage.

  3. Cancer patients: Patients who have undergone surgery to remove skin cancer or other types of tumors may need skin graft surgery to repair the wound and improve the appearance of the skin.

  4. Patients with chronic wounds: Skin graft surgery can be used to treat chronic wounds that have not healed properly, such as pressure ulcers or diabetic ulcers.

  5. Patients undergoing reconstructive surgery: Skin graft surgery is often used in reconstructive procedures, such as breast reconstruction after a mastectomy or facial reconstruction after trauma or cancer surgery.

Overall, skin graft surgery is recommended for patients who have significant skin loss or damage and who would benefit from the replacement of damaged skin with healthy tissue.

Timeline

Overall, the timeline of a patient’s experience before and after skin graft surgery can be summarized as follows:

Before skin graft surgery:

  1. Initial consultation with a plastic surgeon to discuss the need for skin graft surgery and the potential risks and benefits.
  2. Pre-operative preparations such as medical history review, physical examination, and possibly blood tests or imaging studies.
  3. Consent form signing and discussion of anesthesia options.
  4. Pre-operative instructions such as fasting before surgery and any necessary medication adjustments.
  5. Marking of the donor and recipient sites on the skin.
  6. Arrival at the hospital or surgical center on the day of surgery.

After skin graft surgery:

  1. Recovery in the post-anesthesia care unit (PACU) immediately after surgery.
  2. Monitoring for any signs of complications such as infection or poor blood flow to the graft site.
  3. Pain management and wound care instructions.
  4. Hospital stay for several days to monitor the healing process.
  5. Follow-up appointments with the plastic surgeon to assess the graft site and remove any sutures or dressings.
  6. Physical therapy or rehabilitation to improve function and mobility in the affected area.
  7. Long-term follow-up to monitor for any potential issues with scarring or graft rejection.

Overall, the timeline of a patient’s experience before and after skin graft surgery can vary depending on the individual case and the specific type of surgery performed. It is important for patients to follow their surgeon’s instructions closely and attend all follow-up appointments to ensure the best possible outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about skin graft surgery include:

  1. What type of skin graft will be used to close the donor site after the RFFF procedure – full-thickness skin graft (FTSG) or split-thickness skin graft (STSG)?
  2. What are the potential complications associated with each type of skin graft closure?
  3. How will the choice of skin graft closure affect the function and appearance of my forearm and hand?
  4. What is the expected recovery time and rehabilitation process after the skin graft surgery?
  5. Are there any specific post-operative care instructions or precautions I should follow to promote optimal healing?
  6. How will the success of the skin graft closure be monitored and evaluated in the weeks and months following the surgery?
  7. What are the potential long-term effects or complications that could arise from the skin graft surgery?
  8. Are there any alternative closure techniques or procedures that could be considered for the donor site?
  9. How experienced is the surgical team in performing RFFF procedures and skin graft closures, and what is their success rate with these surgeries?
  10. Are there any research studies or clinical trials that I could participate in to further advance knowledge and treatment options for skin graft surgery?

Reference

Authors: Moors JJE, Xu Z, Xie K, Rashad A, Egger J, Röhrig R, Hölzle F, Puladi B. Journal: Syst Rev. 2024 Feb 26;13(1):74. doi: 10.1186/s13643-024-02471-x. PMID: 38409059