ABSTRACT
The radial forearm is a popular free flap site for reconstruction of head and neck
defects, because of its abundant, pliable, skin component and an available, extended,
vascular pedicle. In addition, vascularized composite flaps, including a segment of
radius, can be designed for skeletal stabilization. The donor-site defect can involve
various complications, including loss of skin graft, unsatisfactory appearance, numbness,
and radial fracture. Recent advances in reducing donorsite defect problems have included
the use of rotation skin flaps, local muscle rotation, and soft-tissue expansion;
however, each of these has its own limitations. Two cases are presented in which radial
forearm donor site defects, measuring less than 4 cm × 6 cm, were primarily closed
successfully with z-plasties based on the longitudinal skin incision. Each patient
has regained preoperative mobility, and prompt primary healing was achieved without
complications.
