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. 2024 Sep 12;60(9):1487.
doi: 10.3390/medicina60091487.

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

Seungeun Hong  1
Affiliations

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

Seungeun Hong. Medicina (Kaunas). .

Abstract

Background and Objectives: 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. Materials and Methods: 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. Results: 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). Conclusions: 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.

Keywords: acellular dermal matrix; donor site complication; hypertension; radial forearm flap.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of this study; in the collection, analyses, or interpretation of data; in the writing of this manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart depicting the patient selection and study design.
See this image and copyright information in PMC

References

    1. Liu W.W., Li H., Guo Z.M., Zhang Q., Yang A.K., Liu X.K., Song M. Reconstruction of soft-tissue defects of the head and neck: Radial forearm flap or anterolateral thigh flap? Eur. Arch. Otorhinolaryngol. 2011;268:1809–1812. doi: 10.1007/s00405-011-1548-4. - DOI - PubMed
    1. Van Caenegem E., Verhaeghe E., Taes Y., Wierckx K., Toye K., Goemaere S., Zmierczak H.-G., Hoebeke P., Monstrey S., T’Sjoen G. Long-term evaluation of donor-site morbidity after radial forearm flap phalloplasty for transsexual men. J. Sex. Med. 2013;10:1644–1651. doi: 10.1111/jsm.12121. - DOI - PubMed
    1. Cho A., Hall F.T. Review of perforator flaps in head and neck cancer surgery. Curr. Opin. Otolaryngol. Head Neck Surg. 2016;24:440–446. doi: 10.1097/MOO.0000000000000293. - DOI - PubMed
    1. Lu J.C.-Y., Zelken J., Hsu C.-C., Chang N.-J., Wei F.-C., Lin C.-H. Algorithmic approach to anterolateral thigh flaps lacking suitable perforators in lower extremity reconstruction. Plast. Reconstr. Surg. 2015;135:1476–1485. doi: 10.1097/PRS.0000000000001168. - DOI - PubMed
    1. Peña I., de Villalaín L., García E., Junquera L.M., de Vicente J.C. Use of autologous skin equivalents with artificial dermal matrix (integra) in donor site coverage in radial forearm free flaps: Preliminary cases. J. Oral Maxillofac. Surg. 2012;70:2453–2458. doi: 10.1016/j.joms.2011.10.028. - DOI - PubMed

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