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u r t s p v u p r Over the past 20 years, microvascular free tissue transfer has become the primary choice for reconstruction of acquired or developmental defects of the head and neck. Multiple free flaps have been described and used for reconstruction of the inherently challenging defects of this region, effectively meeting the demands of reestablishing form and function. The radial forearm free flap is particularly popular because of ease of harvest, versatility, minimal morbidity, and predictable successful outcomes. Although the radial forearm free flap is highly reliable, there remains the problem of closing the distal forearm donor site defect. Primary closure is not feasible in most of these defects because of the paucity of soft tissues in the area, as well as the potential of placing the distal upper extremity in danger of ischemia. Although the iterature is replete with a variety of techniques for losure of these defects, currently there remains no dopted standard procedure. Multiple sites have been discussed for harvest of ull-thickness skin graft (FTSG), particularly the skin f the abdomen and groin. At our center, we favor the