Harvesting of Free Grafts for Head and Neck Surgery

Abstract

The concave deformity following total parotidectomy is the main source of cosmetic morbidity and postoperative dissatisfaction. Free abdominal fat graft is a safe and effective way to correct this defect. Careful patient selection and proper surgical technique are needed for a satisfactory long-term result.

The fascia lata is the deep fascia of the thigh and extends from the superior margin of the bony pelvis to the knee joint. The fascia is thickest laterally, which is harvested for use as graft. The technique of harvesting fascia lata using a Crawford stripper used to be safe and satisfactory.

The sural nerve is most commonly used for both peripheral and central nerve grafting. It is readily accessible and provides 30–40 cm of usable graft. It results in minimal sensory deficit of the donor area, postoperative scarring, and morbidity.