Free Flap Donor-Site Complications and Management

Abstract

Free flap harvest will occasionally result in donor-site complications and morbidity. Most of these complications are managed simply without producing lingering effects on activities of daily living. However, some patients will sustain limb weakness, gait issues, chronic pain, and nonhealing wounds. Frank preoperative discussion between surgeon and patient is essential to maximize postoperative outcome and manage expectations. Fastidious surgical technique will help minimize the risks of hematoma, seroma, and infection, while newer techniques can help prevent some issues with wound healing, limb weakness, and sensory changes. In this article, we describe the rates of common and rare complications at free flap donor sites, as well as techniques to prevent and manage them.

Rekonstruktion von Defekten im Kopf-Hals-Bereich nach Tumorresektionen

“…Neben den zuvor beschriebenen möglichen Hypästhesien und Krafteinschränkungen kommt es hier häufig zu Hämatomen, Seromen oder Wundheilungsstörungen mit Dehiszenzen, Nekrosen der transplantierten Haut und in der Folge freiliegenden Sehnen. Der Verschluss des Hebedefekts mittels Hauttransplantat ergibt in diesem motorisch im Alltag häufig beanspruchten Gebiet nicht immer ein ästhetisch und funktionell zufriedenstellendes Ergebnis [13,14].…”

Closed Incision Negative-Pressure Therapy on Free Flap Donor Sites: A Meta-analysis of Postoperative Outcomes

“…Closed incision negative pressure therapy (ciNPT) is a potential alternative to conventional dressings for management of free flap donor sites. 1 , 2 Although traditionally applied to open wounds, negative-pressure wound therapy has been used in management of surgical wounds and has been associated with a decreased risk of surgical site infection. 3 , 4 Negative-pressure wound therapy accelerates wound healing through promotion of blood flow, expression of growth factors, and removing excess fluid while maintaining a closed environment that holds the wound edges together.…”

Successful repair of an encephalocele wound in a child following a car accident: A case report

“…Nutrition is supplied to the flap through microvascular anastomosis surgery and vascular anastomosis in the recipient area. The advantages of free flap reconstruction include selection of well-matched tissue, shape plasticity and reliable vascularity (3). Although free flap surgery in children is challenging, several studies have shown the same or even higher success rates as in adults (4,5).…”