Learning Objectives: Identify factors associated with skin graft take in fibula free flaps (FFF) and radial forearm free flaps (RFFF) donor sites.
Study Objectives: To determine which factors are associated with decreased skin graft take at the donor site in FFF and RFFF in head and neck patients.
Design: Retrospective Chart Review Case Series.
Setting: Multicenter Tertiary Care.
Methods: A multicenter retrospective review was performed at three institutions identifying patients who underwent free tissue transfer, specifically either FFF or RFFF, between 2007 and 2017. Patient demographics, medical history, and social history were examined including age, gender, BMI, smoking status, diabetes and preoperative anticoagulation use. Preoperative, intraoperative data, and postoperative data were also examined including tourniquet use, type of flap, area of skin graft, if the skin graft had a donor site or if it was taken from the flap, wound NPWT use, cast use, use of physical therapy, DVT prophylaxis, limb ischemia, heparin drip, and postoperative aspirin use. Statistical analysis was used to determine which factors were significantly associated with skin graft take.
Results: 1415 patients underwent a forearm or fibula flap and 938 patients underwent split-thickness skin graft. Of these, 592 patients had sufficient information and were included in the final analysis. There were 371 males and 220 females. The average age was 55.7. Complete skin graft take was seen in 480 patients (81.1%). On univariate analysis, patients with diabetes (p = .003), type of flap (fibula p < .001), skin graft area (p = .006), tourniquet use (p = .003), DVT prophylaxis (p = .008) and casting (p = .003) were significantly associated with decreased skin graft take rate. In a multivariate analysis, diabetes (OR 2.17 (95%CI 1.16-3.98)), fibula flaps (OR 2.86 (95%CI 1.79-4.76)), an increase in skin graft area (OR 1.01 (95%CI 1.01-1.01)), post-operative aspirin (OR 2.63 (95%CI 1.15-5.88), and casting (OR 2.94 (95%CI 1.22-7.14)) were associated with poor rates of skin graft take.
Conclusion: Several factors affect skin graft take rate and should be considered when performing a skin graft for a donor site defect.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjoto.2020.102536 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
First Palmar Intermetacarpal Flap for Congenital First Web Contracture: A Case Series.
Microsurgery
January 2025
Pediatric Hand Surgery and Microsurgery, Barcelona Children's Hospital, HM Nens, HM Hospitales, Barcelona, Spain.
Background: Pediatric first web space contractures of the hand can lead to disability in hand function. Several techniques have been proposed for treating this condition. Recently, a new technique involving the first palmar cutaneous flap was described in a cadaveric study.
View Article and Find Full Text PDFImpact of Tacrolimus, Sirolimus, Age, and Body Mass Index on the Occurrence of Skin Cancer and Islet Dysfunction After Transplantation.
Cell Transplant
January 2025
Department of Translational Research & Cellular Therapeutics, Arthur Riggs Diabetes & Metabolism Research Institute, City of Hope, Duarte, CA, USA.
Herein, we characterized the percentage of tacrolimus to the combined sirolimus and tacrolimus trough levels (tacrolimus %) observed during islet transplant-associated immune suppression therapy with post-transplant skin cancer. Although trough levels of tacrolimus and sirolimus were not different ( = 0.79, 0.
View Article and Find Full Text PDFReconstruction of trunk debridement after necrotizing fasciitis complicating varicella lesions with NovoSorb biodegradable temporizing matrix and skin graft: A pediatric case report.
Ann Chir Plast Esthet
January 2025
Department of Plastic and Burns Pediatric Surgery, Hôpital Armand-Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
This clinical case report describes the reconstructive management of a child who developed a rare aggressive soft tissue infection - necrotizing fasciitis - complicating varicella skin lesions, with a synthetic dermal regenerative template - NovoSorb Biodegradable Temporizing Matrix - in conjunction with a split thickness meshed skin graft. The scarcity of this clinical case, the need to cover large skin defect promptly while facing infectious and pediatric challenges make it interesting to describe NovoSorb Biodegradable Temporizing Matrix in addition to split thickness meshed skin graft a novel treatment in necrotizing fasciitis of the child. A rapid surgical treatment followed by this reconstructive strategy achieved an acceptable functional and aesthetic result, with timely healing despite the severity and extensive surface area of the infection.
View Article and Find Full Text PDFSprayable, antimicrobial and immunoregulation hydrogel loading exosomes based on oxidized sodium alginate for efficient wound healing at skin graft donor sites and health detection.
Carbohydr Polym
March 2025
School of Materials Science and Engineering, Tongji University, Shanghai 201804, PR China. Electronic address:
Skin grafting techniques are widely used for large burns, trauma, and various acute and chronic wounds, contributing greatly to the repair of traumatic tissue. However, donor site repair and regeneration are often neglected, resulting in infection and delayed healing. Therefore, it is crucial to reduce the rate of donor site infection and improve the speed and quality of healing.
View Article and Find Full Text PDFMelanoma Among Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.
J Clin Oncol
January 2025
Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
Purpose: Melanoma as a subsequent malignant neoplasm has been described among childhood cancer survivors; however, the risk factors and long-term survival are not well understood.
Methods: We assessed incidence, risk factors, and outcomes for melanoma among participants in the Childhood Cancer Survivor Study cohort. Cumulative incidence and standardized incidence ratios (SIRs) were calculated, and multivariable Cox models were used to determine hazard ratios (HRs) and associated 95% CI for melanoma risk factors.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!