We read with great interest the article entitled ''Reconstruction of the Radial Forearm Free Flap Donor Site Using Integra Artificial Dermis'' by Murray et al. 1 The authors following suprafascial dissection of a free radial forearm flap, they provided coverage of the donor site with Integra artificial dermis, reporting negligible donor site complications, excellent cosmesis, and minimal scar contracture. 1 These results are consistent with our study, which showed that suprafascial dissection of the forearm flap creates a superior graft recipient site for the Integra artificial dermis, resulting in an excellent functional and aesthetic outcome. 2 Given that the suprafascial is considered technically more demanding compared to the conventional subfascial dissection, 3 a reasonable issue is raised: is the artificial dermis able to ensure minimal donor-site morbidity without the aid of the suprafascial technique?
Aiming to answer this question, we assessed the donor site morbidity after subfascial harvesting of the radial forearm flap and coverage with Integra artificial dermis, in four patients who underwent partial glossectomy reconstruction. The flaps were dissected subfascially intending to give more bulk to the reconstructed tongue. A dorsal support splint was applied and gentle physiotherapy commenced the first postoperative day. Complete take of the Integra was recorded, the splint was removed, and the full range of