Our Summary

This research paper looks at a common surgical procedure called the radial forearm free flap (RFFF), often used in microvascular reconstructions. A concern with this procedure is the possible complications at the site where the tissue was taken from, which can include issues with wound healing, functional problems, and cosmetic concerns. The surgeons typically use either full-thickness skin grafts (FTSG) or split-thickness skin grafts (STSG) to close the donor site, but it’s not clear which method is better in terms of reducing complications.

To find out, the researchers looked at 15 studies involving 933 cases where the donor site was closed either with FTSG or STSG. They didn’t find any significant difference between the two methods in terms of major or minor wound complications.

The conclusion is that neither method is conclusively better in terms of wound healing, function, or cosmetic outcomes. Further, well-designed studies are needed to provide better guidance for surgeons. Until then, the best choice between FTSG and STSG should be based on the specific circumstances of each patient, including surgical factors and the characteristics of the donor site.

FAQs

  1. What is the radial forearm free flap (RFFF) procedure and why is it used?
  2. What are the potential complications of the RFFF procedure at the tissue donor site?
  3. Is there a significant difference in complications between using full-thickness skin grafts (FTSG) and split-thickness skin grafts (STSG) for closing the donor site?

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 attending follow-up appointments as scheduled. It is important to communicate any concerns or changes in the graft site to your healthcare provider promptly.

Suitable For

Patients who are typically recommended skin graft surgery include those who have suffered extensive burns, traumatic injuries, or have undergone surgery to remove cancerous tissue. Skin graft surgery may also be recommended for patients with chronic wounds that are not healing properly, or for those who have undergone reconstructive procedures such as breast reconstruction or scar revision. Additionally, skin graft surgery may be recommended for patients with certain skin conditions such as vitiligo or large birthmarks that are affecting their quality of life.

Timeline

Before skin graft surgery:

  • Patient meets with surgeon to discuss the procedure and potential risks
  • Patient undergoes pre-operative tests and evaluations
  • Patient may need to stop certain medications or adjust their lifestyle habits leading up to the surgery

After skin graft surgery:

  • Patient is monitored closely for any signs of infection or complications
  • Patient may experience pain, swelling, and discomfort at the graft site
  • Patient may need to wear compression garments or dressings to support the healing process
  • Patient undergoes follow-up appointments to monitor healing progress and address any concerns
  • Patient may need physical therapy or rehabilitation to regain function in the affected area
  • Patient may need to follow a specific skincare routine to minimize scarring and promote optimal healing.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with skin graft surgery?
  2. How long will it take for the donor site to heal after the procedure?
  3. Will I need any special wound care or follow-up appointments after the surgery?
  4. How will the appearance of the donor site be affected by the skin graft procedure?
  5. Are there any specific factors that may make me a better candidate for either a full-thickness or split-thickness skin graft?
  6. What is the expected outcome in terms of function and cosmetic appearance following the skin graft surgery?
  7. How long will it take for the skin graft to fully integrate and heal on the recipient site?
  8. Are there any restrictions or limitations I should be aware of during the recovery period?
  9. What are the success rates for skin graft surgery, and what factors may impact the outcome?
  10. Are there any alternative treatment options available that I should consider before undergoing skin graft surgery?

Reference

Authors: Moors JJE, Xu Z, Xie K, Rashad A, Vladu O, Egger J, Röhrig R, Hölzle F, Puladi B. Journal: Syst Rev. 2025 May 27;14(1):118. doi: 10.1186/s13643-025-02863-7. PMID: 40426263