Radial Forearm Free Flap Donor Site Outcomes Comparison by Closure Methods

Ho, Tang; Couch, Marion E.; Carson, Kathryn A.; Schimberg, Amy; Manley, Karen; Byrne, Patrick J.

doi:10.1016/j.otohns.2005.09.019

Cited by 72 publications

(70 citation statements)

References 24 publications

(47 reference statements)

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“…Most of the complaints are about poor appearance (2%Y8%), delayed wound healing with partial failure of the skin graft (2%Y53%), exposure of tendons (0%Y33%), contracture of scars (11%), sensory impairment of the donor hand (17%Y54%), and cold intolerance (27%). 12,13 To overcome these complications, alternative ways of restoring the radial forearm free flap donor site other than split thickness skin graft have been explored; these include full thickness skin grafts, 14 acellular dermal matrix (Alloderm), 14 and negative pressure wound dressings. The Alloderm, composite graft of acellular dermal matrix and ultrathin split thickness skin graft, produced greater patient satisfaction and functional recovery of the forearm.…”

Section: Discussionmentioning

confidence: 99%

Modified Folding Radial Forearm Flap in Soft Palate and Tonsillar Fossa Reconstruction

Kang

Park

Lim

et al. 2013

Journal of Craniofacial Surgery

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Wide excision of cancer arising from the tonsillar fossa and soft palate has several functional sequelae (e.g., speech, swallowing, chewing, and breathing) that require surgical restoration of the pharyngeo-palatal structure and optimal velopharyngeal function. For this purpose, several kinds of surgical procedures have been introduced. Our method to reconstruct the tonsillar fossa and soft palate entails folding the flaps and reconstructions at the same time as the oral and nasal planes, with some modifications.Patient 1 was a 64-year-old man with left soft palate cancer. After wide excision of the tumor, the defect size of the nasal floor was 3 × 3 cm, and that of soft palate and tonsillar fossa was 8 × 5 cm. Patient 2 was a 49-year-old man with left tonsil cancer. The defect size of the nasal floor was 3 × 3 cm, and that of left lateral wall of the tonsillar fossa was 8 × 3 cm. For reconstruction of oral, nasal, and tonsillar plane, we designed the flap fit to the defect site, especially cutting of the edge of the square plane of the flap to a round shape.Both patients achieved good functional recovery without surgical complications. The average speech intelligibility score in the 2 patients was 10. Swallowing functional score was 4 in both patients. Creative reconstruction with modified radial forearm free flap for tonsillar and soft palate area makes it possible to restore velopharyngeal function to levels close to the preoperative condition.

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Section: Discussionmentioning

confidence: 99%

Modified Folding Radial Forearm Flap in Soft Palate and Tonsillar Fossa Reconstruction

Kang

Park

Lim

et al. 2013

Journal of Craniofacial Surgery

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“…In a comparative study of RFF donor site closure methods, Ho et al [4] studied three techniques for donor site repair, STSG, STSG with AlloDerm and FTSG. They found that the group of patients reconstructed with STSG alone achieved the highest esthetic outcome ratings .…”

Section: Discussionmentioning

confidence: 99%

“…Techniques such as direct closure, prelamination or full thickness skin graft (FTSG) instead of split thickness skin graft (STSG) at RFF donor defect have been employed, but STSG is still the method of choice for many surgeons [2][3][4][5], including those at our institute, Seoul National University Dental Hospital.…”

Section: Introductionmentioning

confidence: 99%

Functional and esthetic assessment of radial forearm flap donor site repaired with split thickness skin graft

Lee

Alrashdan

Kim

et al. 2010

Eur Arch Otorhinolaryngol

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The purpose of this study was to evaluate the long-term functional and esthetic outcomes of radial forearm flap (RFF) donor site repaired with split thickness skin graft (STSG). Nineteen patients underwent surgical reconstruction of oro-facial defects by the use of RFF and their donor sites were reconstructed with STSG. The patients were followed up at least for 12 months postoperatively and the left hand was the non-dominant hand in all of them. Objective methods including pinch strength, grip strength, range of motion, current perception threshold (CPT) and two-point discrimination, and subjective methods including patients interview, visual analogue score (VAS) about function, sensitivity, pain and color match, were collectively employed for donor site assessment. Our data revealed some degree of reduction in motor function and sensation compared to the non-donor hand. The difference of pinch strength means was 9.81% and of the grip strength was 12.6%. The difference of wrist flexion means was 17.6% and of wrist extension was 13.4%. However, none of the patients had functional defects of forearm supination and pronation, wrist ulnar deviation or wrist radial deviation. Subjective evaluation showed that the donor site repaired with STSG was well accepted by the patients particularly from a functional point of view. These results demonstrate that STSG represents a favorable choice for RFF donor site repair.

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“…The theoretical advantage of the improved cosmetic appearance is appealing, but a recent study in the head and neck cancer literature showed no statistical difference in aesthetic or functional outcomes when comparing donor sites closed with split thickness grafts, full thickness grafts and Alloderm plus split thickness grafts. It was a small study, but the perceived benefit of using the dermal substitute may be more theoretical than real [10].…”

Section: Additional Usesmentioning

confidence: 99%

Soft tissue coverage of the hand and wrist

Hammert¹,

Tomaino²

2007

Current Opinion in Orthopaedics

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Radial Forearm Free Flap Donor Site Outcomes Comparison by Closure Methods

Abstract: Each of the 3 methods of reconstruction has low morbidity and satisfactory aesthetic and functional outcomes.

Cited by 72 publications

References 24 publications

Modified Folding Radial Forearm Flap in Soft Palate and Tonsillar Fossa Reconstruction

Modified Folding Radial Forearm Flap in Soft Palate and Tonsillar Fossa Reconstruction

Functional and esthetic assessment of radial forearm flap donor site repaired with split thickness skin graft

Soft tissue coverage of the hand and wrist

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