Radial Forearm Donor Site Closure

The radial forearm free flap (RFFF) is widely used in head and neck reconstruction. Its thinness, pliability, pedicle length, and vessel size are particularly suited for oropharyngeal and oral cavity reconstruction. Concerns about aesthetic and functional morbidity at the donor site have given rise to various techniques of closing the donor site, two of which are the split-thickness skin graft (STSG), taken from the thigh, and the hatchet flap, which uses a local flap within the radial forearm. This RCT will determine whether retrospectively reported improvements to aesthetic and functional outcomes for STSG patients are greater compared to hatchet flap patients.

Inclusion Criteria:Adults aged 18 or olderOral cavity disease (malignant or benign) requiring radial forearm free flap reconstructionExclusion Criteria:Serious medical comorbidities including metastatic disease or other contraindications to surgeryAny pre-existing condition affecting the use of both hands, including previous major scarsUnable or unwilling to complete post-operative questionnaires in EnglishPregnant or lactating women