Abstract：
BACKGROUND: The radial forearm flap (RFF) is one of the most commonly used flaps in reconstructive surgery. Split-thickness skin grafting (STSG) has traditionally been used for closure of the forearm. However, full-thickness skin grafting (FTSG) has gained in popularity to achieve more satisfactory results. The aim of the study is to identify the best RFF donor site closure technique by comparing the functional and aesthetic outcomes of STSG and FTSG.
METHODS: PubMed and EMBASE databases were queried. Only studies comparing complications rate, functional and aesthetic outcomes between STSG and FTSG were included. The primary outcome was graft failure rate. Secondary outcomes included the aesthetic result and functionality of the forearm/wrist.
RESULTS: A total of 13 studies were included in this review, accounting for a total of 712 patients with mean age of 60.7 years. Overall, 348 patients underwent FTSG and 377 underwent STSG. The mean follow-up was 14.7 months. The rate of graft failure in FTSG was significantly higher compared to STSG (OR: 2.79, 95 % CI 1.38-5.65, p = 0.004). There was no significant difference in rate of tendon exposure (OR: 0.83, p = 0.65) and infection (OR: 1.37, p = 0.42). Regarding the aesthetic outcome, no significant difference between FTSG and STSG based on observer (SMD = -0.37, p = 0.17) and patient (SMD = -0.016, p = 0.93) assessment, respectively. Overall postoperative functional assessment showed a not severely impaired hand and arm function in both groups. Subjective evaluation of pain was similar between groups.
CONCLUSIONS: FTSG is associated with higher risk of graft failure than STSG in RFF donor site closure, without significant improvement in aesthetic results.
METHODS: PubMed and EMBASE databases were queried. Only studies comparing complications rate, functional and aesthetic outcomes between STSG and FTSG were included. The primary outcome was graft failure rate. Secondary outcomes included the aesthetic result and functionality of the forearm/wrist.
RESULTS: A total of 13 studies were included in this review, accounting for a total of 712 patients with mean age of 60.7 years. Overall, 348 patients underwent FTSG and 377 underwent STSG. The mean follow-up was 14.7 months. The rate of graft failure in FTSG was significantly higher compared to STSG (OR: 2.79, 95 % CI 1.38-5.65, p = 0.004). There was no significant difference in rate of tendon exposure (OR: 0.83, p = 0.65) and infection (OR: 1.37, p = 0.42). Regarding the aesthetic outcome, no significant difference between FTSG and STSG based on observer (SMD = -0.37, p = 0.17) and patient (SMD = -0.016, p = 0.93) assessment, respectively. Overall postoperative functional assessment showed a not severely impaired hand and arm function in both groups. Subjective evaluation of pain was similar between groups.
CONCLUSIONS: FTSG is associated with higher risk of graft failure than STSG in RFF donor site closure, without significant improvement in aesthetic results.
摘要：
背景：radial前臂皮瓣（RFF）是重建手术中最常用的皮瓣之一。传统上，厚皮移植（STSG）用于前臂的闭合。然而,全层植皮术（FTSG）已得到普及，取得了更满意的效果。该研究的目的是通过比较STSG和FTSG的功能和美学结果来确定最佳的RFF供体部位闭合技术。
方法：查询PubMed和EMBASE数据库。只有比较并发症发生率的研究，包括STSG和FTSG之间的功能和美学结果。主要结果是移植物失败率。次要结果包括前臂/手腕的美学结果和功能。
结果：本综述共纳入13项研究，共712例患者，平均年龄为60.7岁。总的来说,348例患者接受FTSG，377例接受STSG。平均随访14.7个月。FTSG的移植物失败率明显高于STSG（OR：2.79，95％CI1.38-5.65，p=0.004）。肌腱外露率(OR:0.83,p=0.65)和感染率(OR:1.37,p=0.42)差异无统计学意义。关于美学结果，根据观察者（SMD=-0.37，p=0.17）和患者（SMD=-0.016，p=0.93）评估，FTSG和STSG之间没有显着差异，分别。术后总体功能评估显示，两组的手和手臂功能均未严重受损。两组对疼痛的主观评价相似。
结论：在RFF供体部位闭合中，与STSG相比，FTSG与更高的移植物衰竭风险相关，在美学效果上没有显著改善。
方法：查询PubMed和EMBASE数据库。只有比较并发症发生率的研究，包括STSG和FTSG之间的功能和美学结果。主要结果是移植物失败率。次要结果包括前臂/手腕的美学结果和功能。
结果：本综述共纳入13项研究，共712例患者，平均年龄为60.7岁。总的来说,348例患者接受FTSG，377例接受STSG。平均随访14.7个月。FTSG的移植物失败率明显高于STSG（OR：2.79，95％CI1.38-5.65，p=0.004）。肌腱外露率(OR:0.83,p=0.65)和感染率(OR:1.37,p=0.42)差异无统计学意义。关于美学结果，根据观察者（SMD=-0.37，p=0.17）和患者（SMD=-0.016，p=0.93）评估，FTSG和STSG之间没有显着差异，分别。术后总体功能评估显示，两组的手和手臂功能均未严重受损。两组对疼痛的主观评价相似。
结论：在RFF供体部位闭合中，与STSG相比，FTSG与更高的移植物衰竭风险相关，在美学效果上没有显著改善。
