Closure of the radial forearm donor site using a local hatchet flap: analysis of 45 consecutive cases.

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(2); 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.