Sternocleidomastoid contour restoration: an added benefit of the anterolateral thigh free flap during facial reconstruction

Naunheim, Molly; Seth, Rahul; Knott, P. Daniel

doi:10.1016/j.amjoto.2015.09.014

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…Interestingly, many of the comparisons were found to be statistically significant even when using the more stringent Tukey-Kramer method. For example, the ALT and fibula skin paddle groups had significantly Age at surgery (yr) Mean (SD) 69 ( 14) 61 ( 19) 62 ( 13) 69 ( 8) 67 (13) 72 (12) .43…”

Section: Resultsmentioning

confidence: 99%

“…[6][7][8][9][10] This underlies the importance of high-fidelity, sophisticated, and ambitious paradigms for facial reconstruction among patients undergoing ablative head and neck surgery. Many advances have been made recently in the restoration of pre-morbid cervicofacial contour among patients undergoing large-volume facial resections 11,12 as well as the optimization of facial movement following paralyzing disorders. 13 Heretofore, color match in cutaneous facial reconstruction has remained a very frustrating endeavor.…”

Section: Introductionmentioning

confidence: 99%

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Skin Color Match in Head and Neck Reconstructive Surgery

et al. 2021

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Objectives/Hypothesis To quantify the degree of color match achieved during microvascular facial reconstruction, and to describe a novel technique for improving reconstructive skin color match. We hypothesize that split‐thickness skin grafts (STSG) placed atop de‐epithelialized free tissue produces better facial skin color match than free tissue with intact epithelium. Study Design Cross sectional photographic study of reconstructed facial skin color match. Methods Sixty‐eight adults, who underwent head and neck reconstructive surgery, were divided into six categories based on cutaneous reconstructive technique: cervicofacial flap, radial forearm free flap (RFFF), fibula free flap, anterolateral thigh free flap (ALT), STSG over adiopofascial flap (STAFF), and STSG over myogenous flap (STMF). Averaged color samplings of the reconstructed defect and adjacent normal skin were taken from digital photographs. The color difference was calculated using the delta‐E calculation. Blinded expert observers also rated the degree of color match. Nonparametric cohort contrast and correlation statistical analyses were performed. Results The mean delta‐E's and 10‐point Likert ratings for the ALT, fibula, RFFF, STAFF, STMF, and cervicofacial flaps were 11.6, 10.0, 7.7, 6.3, 8.8, and 4.7, and 5.1, 6.4, 2.4, 3.2, 2.7, and 1.1, respectively. Likert scale inter‐rater correlation was strong, with coefficient = 0.80. Conclusions On average, STSG over de‐epithelialized myogenous and adipofascial free tissue transfers produced a better color match than the skin paddles of donor sites, with the exception of the radial forearm donor site. Delta‐E values obtained from photos correlated well with expert ratings of color match. This reliable technique for quantifying color match may be used in future studies. Level of Evidence 3 Laryngoscope, 132:1753–1759, 2022

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Skin Color Match in Head and Neck Reconstructive Surgery

et al. 2021

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“…The availability of various tissue types at the donor site allows for fasciocutaneous, myocutaneous, myofascial, and/or adipofascial flap harvesting 2,3 . As a result, the ALT free tissue donor site is highly versatile and permits reconstruction of a wide variety of defects requiring skin coverage, soft tissue volume, internal nasal lining, bone, and cutaneous defects, or even vascularized facial nerve reconstruction 4–9 . Complications are uncommon, but may result in extended hospital stay, additional surgical interventions, and increased cost to the healthcare system 10 .…”

Section: Introductionmentioning

confidence: 99%

“…2,3 As a result, the ALT free tissue donor site is highly versatile and permits reconstruction of a wide variety of defects requiring skin coverage, soft tissue volume, internal nasal lining, bone, and cutaneous defects, or even vascularized facial nerve reconstruction. [4][5][6][7][8][9] Complications are uncommon, but may result in extended hospital stay, additional surgical interventions, and increased cost to the healthcare system. 10 Seroma is the most common donor site complication and may occur in $5%-6% of cases.…”

Section: Introductionmentioning

confidence: 99%

Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications

David

Zebolsky

Park

et al. 2022

Laryngoscope Investig Oto

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Background: Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction.The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting.Methods: Prospective, single-blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1-3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection.Results: Twenty-nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1-3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion:MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation.

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