The use of artificial dermis on the donor defect of the free forearm flap.

Microsurgical grafting of a free flap is an established technique of surgical reconstruction. The forearm free flap is frequently used following removal of oral and/or pharyngeal tumors. However, simple split-thickness skin grafting on full-thickness defects of the skin on the flexor side of the forearm results in deformations, pigmentation, and the adhesion of the graft to the tendons. The authors attempted to minimize such problems by repairing the flap donor site with a collagen sponge used as an artificial dermis. This artificial dermis was used to reconstruct postoperative defects in the skin of 5 patients. Split-thickness skin measuring 0.25 to 0.30 mm was grafted onto the defect. The donor site skin was successfully repaired in 2 to 3 weeks without adverse effects, without the development of depressed deformations, and with only slight pigmentation. The artificial dermis formed a matrix on the donor wound bed, with good cosmetic results.