Radially Pedicled In-Situ Split-Thickness Skin Grafts, an Alternative to Distal Split-Thickness Skin Grafts

Objective. This study aimed to introduce a novel radially pedicled in-situ split-thickness skin graft (STSG). The morbidity, esthetic, and functional outcomes of the radially pedicled in-situ STSG were in comparison with those of the distal STSG. Study Design. Retrospective analysis. Setting. A single-institution review. Methods. Seventy patients with oral cancer who underwent radical surgical resection and simultaneous radial forearm free flap (RFFF) reconstruction from July 2021 to March 2022 were included. De-epithelialized RFFFs and traditional RFFFs were used to repair oral defects of 35 patients in Group A and Group B, respectively, while radially pedicled in-situ STSGs and distal STSGs taken from abdomens were used to repair donor site defects in the above groups, respectively. Patient demographics, wound healing complications, and esthetic and functional outcomes of the forearms were compared between the 2 groups. Results. No significant difference between Group A and Group B was observed in terms of donor site and recipient site complications. The esthetic outcome was superior in Group A compared to Group B (P =.011). The extension range, sensation, and pinch strength of operated forearms were significantly reduced in both groups after surgery (P <.05), however, intergroup differences were not observed. Conclusion. Taken together, our results suggest that radially pedicled in-situ STSG is an applicable technique for direct closure and better esthetic outcomes in the forearm donor site.