gms | German Medical Science

78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2007, München

Aesthetic and functional results of donor site in case of radial forearm flap

Meeting Abstract

Suche in Medline nach

  • corresponding author Alexander Thiele - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
  • Cornelia Wulke - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
  • Stephan Knipping - Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno124

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2007/07hno124.shtml

Veröffentlicht: 8. August 2007

© 2007 Thiele et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The free radial forearm flap is an essential method for reconstruction of defects in the head and neck region. Beside many widely accepted advantages of this flap, including a good moldability, a long vascular pedicle and flexible dimensions, there is still disagreement in literature about the best surgical treatment of the forearm defect to avoid functional and cosmetic drawbacks. Thinkable impairments at the donor site are restriction in hand movement, grip strength reduction, tendon exposure, pain, paraesthesia, cold intolerance, itching, etc. There is a debate about using full skin graft or better utilizing split skin graft.

The motivation for this study was to evaluate our own results after radial forearm flap surgery.

Patients and method: Between the years 1995 and 2006 in the Department of Otorhinolaryngology, Head and Neck Surgery of the Martin-Luther-University Halle-Wittenberg / Germany 53 patients were surgically treated using a free radial forearm flap after excising extensive tumours of the head and neck. On 25 patients it was possible to perform a follow-up examination and standardized interview. To assess the function of the treated forearm we compared it with the contralateral side. For closing the donor defect full skin graft from the groin was used in 17 cases and split skin graft from the thigh in 8 cases.

Results: At the time of follow-up examination all patients were subjective overall satisfied with postoperative result. Especially they did not notice any impairment of hand function for everyday life use. Subjective complaints were more common in the split graft group, especially paraesthesia and cold-intolerance (37,5% split skin graft group vs. 17% full skin graft group).

Because of severe wound healing failure with tendon exposure in one case after split skin grafting, there was the necessity for surgical revision.

Within the medical examination we documented more functional impairments in the split skin graft group than in patients after full skin grafting: paraesthesia (25% vs. 17%) and grip strength reduction (25% vs. 6%). Only the development of hypertrophic scars dominated in the full skin graft group (30% vs. 12,5).

Conclusion: From the patient´s viewpoint the subjective functional and aesthetic results after closure of the radial forearm defect were acceptable not only in the full skin graft group but also in the split skin graft group. By medical examination we documented more functional impairments in patients after split skin grafting. Because of this we conclude, that the full skin graft technique should be preferred for the closure of the donor site after radial forearm flap surgery.