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BACKGROUND: The radial forearm free flap (RFFF) is widely used in reconstructive surgery. Traditional donor-site closure by grafting may be associated with significant aesthetic and functional morbidity. We report our experience with primary closure using a local hatchet flap. METHODS: In all, 45 consecutive patients who underwent RFFF reconstruction in the head and neck during an 8-year period were retrospectively assessed with regards to their donor-site morbidity. RESULTS: The mean age of the patients was 54, with 23 being female. The mean RFFF area harvested was 37.7 cm; mean width, 7.6 cm (5.5-11 cm); and mean length, 4.7 cm (3.5-6.5 cm). All patients had their donor site closed primarily utilizing a local hatchet flap. At the time of follow-up, there were 33 surviving patients, of which 31 patients were available for assessment. CONCLUSIONS: We recommend this technique of primary closure of the RFFF donor site: it is well tolerated by the patient, with good cosmesis and is associated with no discernable functional morbidity.

Original publication




Journal article


Ann plast surg

Publication Date





308 - 312


Adult, Aged, Esthetics, Female, Follow-Up Studies, Forearm, Free Tissue Flaps, Graft Survival, Head and Neck Neoplasms, Humans, Male, Middle Aged, Patient-Centered Care, Reconstructive Surgical Procedures, Retrospective Studies, Skin Transplantation, Tissue Donors, Tissue and Organ Harvesting, Treatment Outcome