RecruitingNot ApplicableNCT05740033

Radial Forearm Donor Site Closure

Functional and Aesthetic Outcomes of Radial Forearm Free Flap Closure Using Split-Thickness Skin Graft vs Primary Closure; a Randomized Control Trial

Sponsor

University of British Columbia

Enrollment

120 participants

Start Date

Feb 1, 2023

Study Type

INTERVENTIONAL

Conditions

Oral Cancer Oral Cavity Cancer Donor Site Complication

Summary

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.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study compares different surgical techniques for closing the wound site on the forearm after skin and tissue is taken from there to reconstruct the mouth or jaw (a procedure called a radial forearm free flap). Researchers want to find which wound closure method heals best and has the least impact on arm function. **You may be eligible if...** - You are 18 years old or older - You have a condition affecting the mouth or jaw (cancerous or non-cancerous) that requires reconstruction using tissue from your forearm - You are able to complete follow-up questionnaires in English **You may NOT be eligible if...** - You have serious health conditions that make surgery too risky (such as metastatic disease) - You have any pre-existing conditions affecting the use of both hands (including major scarring) - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.

This is a simplified summary. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDURESplit-Thickness Skin Graft for Radial Forearm Donor Site Closure

This method is performed by harvesting a 0.014-inch skin graft harvested from the anterolateral thigh on the side of the RFFF to reconstruct the forearm donor site. This skin graft is then used to cover the donor defect. The skin graft is sutured in place with 4-0 chromic suture, and a standard bolster dressing will be applied, and a partial splint will be left in place for five days post-operation.

PROCEDUREHatchet Flap for Radial Forearm Donor Site Closure

The hatchet flap closures will be performed based on prior description by Lane et al. (12), except no drain is placed in situ. A back cut of 3 to 4 cm is made to aid closure (Figure 1). Tension will be minimized by maintaining the wrist in flexion. A mepore dressing will be applied to the donor site post-operatively for two days.