Risk Factors for Postoperative Donor Site Complications in Radial Forearm Free Flaps.

Medicina (Kaunas)

Department of Plastic and Reconstructive Surgery, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, 1071 Gonghangdae-ro 260, Gangseo-Gu, Seoul 07985, Republic of Korea.

Published: September 2024

AI Article Synopsis

  • The radial forearm free flap (RFFF) is commonly used for reconstructing head and neck areas, but donor site complications are a major concern.
  • A study reviewed records from 67 patients who had RFFF procedures from 2015 to 2022, focusing on factors affecting donor site complications like delayed skin healing and sensory changes.
  • Key findings indicated that patients with hypertension faced longer healing times, while diabetes increased risks of sensory issues; using acellular dermal matrix (ADM) for skin grafts could help minimize these neurological problems.

Article Abstract

The radial forearm free flap (RFFF) is the most commonly used flap for head and neck reconstruction. However, complications at the donor site are its major drawbacks. We aimed to identify the patient comorbidities and factors that predict donor site complications after RFFF. A retrospective chart review of consecutive patients who underwent RFFF reconstruction for head and neck cancer between 2015 and 2022 was performed. Demographic variables, clinical processes, and postoperative complications were assessed. All variables were analyzed using univariate and multivariate analyses. Sixty-seven patients underwent RFFF reconstruction, and all received a split-thickness skin graft at the donor site. Twenty-five patients experienced delayed skin graft healing, whereas nine experienced sensory changes at the donor site. Hypertension and age had statistically significant negative effects on wound healing. The incidence of hand swelling was related to graft size, and the occurrence of paresthesia was significantly higher in diabetic patients and significantly lower in those with acellular dermal matrix (ADM). Patients with hypertension had a higher risk of prolonged wound healing after RFFF than their normotensive patients. Clinicians should pay particular attention to wound healing strategies in patients with hypertension. Additionally, better neuropathy care is recommended to achieve sensory recovery after RFFF in patients with diabetes. Using a skin graft with ADM could be a method to alleviate neurological symptoms.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11433851PMC
http://dx.doi.org/10.3390/medicina60091487DOI Listing

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