Background and objectives: To reduce donor site morbidity after radial forearm free flap a novel technique of a local full-thickness skin graft (FTSG) is described.

Methods: In a prospective study of 30 consecutive patients undergoing radial forearm free flap for head and neck reconstruction donor site defects were closed with local spindle-shaped FTSGs that were excised at the wavelike access incision.

Results: Both removal site of the full-thickness skin graft of the volar forearm and the covered radial forearm free flap donor site healed uneventfully in 29 of 30 cases. All patients expressed satisfaction with postoperative pain, functional outcome and cosmetic appearance.

Conclusions: The local FTSG enabled primary donor site defect closure in all cases. It can be gained at the access incision for the vascular pedicle of the donor forearm, avoids expansion of the incision for a local flap technique, does not prolong wound healing and thus reduces both donor site and graft site morbidity of the radial forearm flap. It avoids a secondary donor site and leads to an excellent aesthetic result with apparently no relevant functional deficits.

Key words: radial forearm free flap; donor site morbidity