Subjective morbidity following radial free flap reconstruction in head and neck tumour patients

Abstract

ObjectiveEvaluation of post-operative donor site disability remains unaddressed in radial forearm free flap cases. This study aimed to assess donor site dysfunction following radial forearm free flap harvest using validated general, disease-specific and site-specific disability questionnaires.MethodsIn this retrospective case series of 24 patients at a tertiary academic medical centre, patients were assessed using the Short Form 36 Health Survey, Short Musculoskeletal Function Assessment questionnaire, and Disabilities of the Arm, Shoulder and Hand questionnaire. One-sample z-tests were performed, comparing means of the cohort to controls.ResultsCompared to population controls, the cohort had higher mean scores for the Disabilities of the Arm, Shoulder and Hand questionnaire (18.22 vs 10.1, p < 0.01), and Short Musculoskeletal Function Assessment questionnaire bothersome index (21.44 vs 13.77, p = 0.04), and a lower mean score for the Short Form 36 Health Survey physical component (38.88 vs 50, p < 0.01), indicating a greater disability for the cohort compared to controls.ConclusionRadial forearm free flap harvest causes significant long-term donor site disability in head and neck tumour patients. The Disabilities of the Arm, Shoulder and Hand questionnaire is a concise tool for measuring this dysfunction.

Comparison of patient‐reported upper extremity disability following free flaps in head and neck reconstruction: A systematic review and meta‐analysis

“…Overall, mean DASH scores were low with "minimal to mild disability" scores appreciated across all free flap donor sites evaluated. The RFFF was evaluated in 203 patients across five studies [17][18][19][20][21] with an average postoperative time to DASH administration of 21 months (range 6-44). The pooled mean DASH score was 12.14 (95% CI: 7.40-16.88).…”

Oral cancer reconstructive surgery using the free radial forearm flap (review)

“…разработали опросник для оценки нарушений функции предплечья и кисти в отдаленном периоде после забора лучевого лоскута. При использовании данного опросника авторы выявили долгосрочное нарушение функциональной активности руки, на которой расположена донорская зона [34].…”

Risk Factors for and Cost Implications of Free Flap Take‐backs: A Single Institution Review

“…7 Moreover, donor site morbidity, potential flap failure, and other risks pertinent to the flap of choice must be considered. 8 Treatment of head and neck cancer utilizes significant healthcare resources. There have been multiple studies analyzing the cost implications of preoperative, perioperative, and postoperative care of patients undergoing MFTTone single-institutional study reported mean hospital charges for a free flap totaled $32,501 9 ; Overall costs rose to $47,708 when adjusted for inflation.…”

“…These complications are often associated with longer duration of mechanical ventilation, greater fluid shifts, and hemodynamic perturbations 7 . Moreover, donor site morbidity, potential flap failure, and other risks pertinent to the flap of choice must be considered 8 …”