Recycling Full Thickness Skin Graft from Failing Free Flaps in Salvage Procedures

Free flap loss is a dreaded complication in microsurgery. When a second free flap is harvested, the enlarged donor site may not be amenable to primary closure, and a split thickness skin graft (STSG) is necessary. If we salvage the skin portion of the failing flap for subsequent wound closure, we not only minimize additional donor sites, we also reap the many functional and cosmetic advantages of full thickness skin grafts (FTSG) over STSG. The recyclability of salvaged skin is mainly dependent on the warm ischemia time.