Reconstruction of a distal extremity defect using a temporoparietal fascia flap covered with a split-thickness skin graft harvested from the scalp: a cosmetic consideration in donor site selection.

BACKGROUND In reconstructive surgery, the ultimate goal in rebuilding a structure is to provide the most similar substitute from both the functional and structural points of view. At the same time, the reconstructive surgeon should focus on minimizing donor area complications. METHODS In this report, we present our experiences with the reconstruction of distal extremity defects using a free temporoparietal fascia flap in five patients. The flap was subsequently covered with a split-thickness skin graft harvested from the same region of the scalp as the flap donor site. RESULTS By procuring the skin graft from the scalp, the donor sites of both the flap and the skin graft were concealed by hair. The transferred flaps and skin grafts healed uneventfully in all patients without any complications at the donor or recipient site. CONCLUSION We conclude that this combination of harvesting a temporoparietal fascia flap, which has many advantages in reconstructing distal extremity defects, along with a skin graft from the same region as the flap, both hidden by hair, can limit donor site morbidity and achieve optimal reconstructive outcomes.