Radial forearm donor site: comparison of the functional and cosmetic outcomes of different reconstructive methods
Chau, J.; Harris, J.; Nesbitt, P.; Allen, H.; Guillemaud, J.; Seikaly, H.
Journal of Otolaryngology - Head and Neck Surgery 38(2): 294-301
2009
ISSN/ISBN: 1916-0216 PMID: 19442381 Document Number: 637846
To determine which method of fascial dissection and skin graft reconstruction of radial forearm free flap defects has superior functional and cosmetic outcomes. Consenting patients undergoing major head and neck operative resection and reconstruction with a radial forearm free flap were prospectively enrolled and randomized into one of the following four groups: (1) suprafascial dissection with meshed graft reconstruction; (2) suprafascial dissection with sheet graft reconstruction; (3) subfascial dissection with meshed graft reconstruction; and (4) subfascial dissection with sheet graft reconstruction. Functional, cosmetic, and tendon exposure outcomes were collected prospectively with patients and outcome assessors blinded to treatment group assignment. Validated self-report questionnaires and objective functional measures were used. Sixty-two patients met the criteria for inclusion. Analysis revealed that suprafascial dissection with sheet graft reconstruction yielded superior functional, cosmetic, and tendon exposure outcomes. Suprafascial dissection with sheet graft reconstruction should be offered to patients requiring radial forearm free flap reconstruction of major head and neck defects.