Background: After more than a decade of experiences, the radial forearm fasciocutaneous free flap has proven to be a well standardized surgical technique, widely used for its easy application and versatility. The review of the literature shows that most of the contraindications to the use of this flap concern mainly the donor site morbidity. Aim of this work is to evaluate the complications of this surgical technique, to study the functional impairment and the scars secondary to the harvesting of the flap, in order to point out which techniques can contribute to their reduction.

Methods: Seventeen patients submitted consecutively to oral cavity reconstruction using a radial forearm flap, whose donor site has been reconstructed with a full-thickness skin graft have been studied. The postoperative complications have been examined, the functional and aesthetic alteration at the donor site analyzed, with a medium follow-up of 17.5 months.

Results: The study of this series has pointed out not relevant early and middle term postoperative complications, no significant hand or finger motility and sensorial deficiencies associated with a percentage of full aesthetic and functional satisfaction of patients for this treatment higher than 80%.

Conclusions: On the basis of personal clinical experience, even if on a small series of cases, the conclusion is drawn that the functional and aesthetic outcomes depend significantly on the surgical techniques used to harvest the flap and to cover the donor site.

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