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Updated: May 27, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Donor site morbidity of free ulnar forearm flap
Swee T Tan1, Dylan W James, Zachary Moaveni
1Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital, Wellington, New Zealand. swee.tan@huttvalleydhb.org.nz
Background:
The purpose of this study was to evaluate the donor site morbidity of the free ulnar forearm flap (UFF).
Methods:
Consecutive patients undergoing free UFF between 1982 and 2009 were retrospectively reviewed. In addition, detailed assessment of hand function and donor site cosmesis was performed in the most recent 50 patients followed up for at least 12 months.
Results:
In all, 62 of the 242 free UFF donor sites (26%) were closed directly and the remainder required split thickness skin grafting. Donor site complications included total (n = 1) and partial (n = 17) skin graft loss and persistent hypertrophic scarring (n = 4). There was minimal incidence of cold intolerance, parasthesia, and pain; no reduction in joint mobility, grip and pinch strength, and sensory dysfunction, with excellent donor site cosmesis.
Conclusions:
UFF has several advantages, including the possibility of direct closure of the donor defect, and reduced morbidity and excellent donor site cosmesis.
