Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP

인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복

  • Oh, Jung-Hwan (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University)
  • 오정환 (경희대학교 치과대학 구강악안면외과학교실)
  • Published : 2007.05.31
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Abstract

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

Keywords

References

  1. Yang G, Chen B, Gao Y et al : Forearm free skin flap transplantation, Natl Med J China 61 : 1391, 1981
  2. Soutar DS, Sheker LR, Tanner NSB : The radial forearm flap: a versatile method for intraoral reconstruction. Br J Plast Surg 36 : 11, 1983
  3. Brown MT, Couch ME, Huchton DM : Assessment of donor-site functional mobidity from radial forearm fasciocutaneous free flap harvest. Arch Otolaryngol Head Neck Surg 125 : 1371, 1999 https://doi.org/10.1001/archotol.125.12.1371
  4. Ho T, Couch M, Carson K et al : Radial forearm free flap donor site outcomes comparison by closure methods : Otolaryngol Head Neck Surg 134 : 309, 2006 https://doi.org/10.1016/j.otohns.2005.09.019
  5. Bardsley A, Souta D, Elliot D et al : Reducing morbidity in the radial forearm flap donor site. Plast Recontr Surg 86 : 287, 1990 https://doi.org/10.1097/00006534-199008000-00014
  6. Elliot D, Bardsley F, Batchelor A et al : Direct closure of the radial forearm flap donor site. Br J Plast Surg 41 : 358, 1988 https://doi.org/10.1016/0007-1226(88)90073-2
  7. Masser M : The pre-expanded radial forearm flap. Plast Reconstr Surg 86 : 295, 1990 https://doi.org/10.1097/00006534-199008000-00016
  8. Hallock G : Refinement of the radial forearm flap donor site using skin expansion. Plast Reconstr Surg 81 : 21, 1988 https://doi.org/10.1097/00006534-198801000-00003
  9. Rowe NM, Morris L, Delacure MD : Acellular dermal composite allografts for reconstruction of the radial forearm donor site. Ann Plast Surg 57 : 305, 2006 https://doi.org/10.1097/01.sap.0000221622.41450.60
  10. Richardson D, Fisher SE, Vaughan ED : Radial forearm flap donor-site complications and morbidity: a prospective study. Plast Reconstr Surg 99 : 109, 1997 https://doi.org/10.1097/00006534-199701000-00017
  11. Swanson E, Boyd JB, Manktelow RT : The radial forearm flap : reconstructive applications and donor-site defects in 35 consecutive patients. Plast Recontr Surg 85 : 258, 1990 https://doi.org/10.1097/00006534-199002000-00016
  12. Timmons MJ, Missotten FEM, Poole MD : Complications of radial forearm flap donor sites. Br J Plast Surg 39 : 176, 1986 https://doi.org/10.1016/0007-1226(86)90078-0
  13. Suominen S, Ahovuo J, Asko-Seljavaara S : Donor site morbidity of radial forearm flaps: a clinical and ultrasonographic evaluation. Scan J Plast Reconstr Surg Hand Surg 30 : 57, 1996 https://doi.org/10.3109/02844319609072405
  14. Kropfl A, Hemberger R, Gasperschitz F : Donor site morbidity following radial forearm flap. Handchir Mikrochir Plast Chir 27 : 72, 1995
  15. Brown MT, Cheney ML, Gliklich RL : Assessment of functional morbidity in the radial forearm free flap donor site. Arch Otolaryngol Head Neck Surg 122 : 991, 1996 https://doi.org/10.1001/archotol.1996.01890210063014
  16. Toschka H, Feifel H, Erli HJ : Aesthetic and functional results of harvesting radial forearm flap, especially with regard to hand function. Int J Oral Maxillofac Surg 30 : 42, 2001 https://doi.org/10.1054/ijom.2000.0005
  17. Swanson E, Boyd J, Mulholland R : The radial forearm flap : a biomechanical study of the osteomized ramus. Plast Reconstr Surg 85 : 267, 1990 https://doi.org/10.1097/00006534-199002000-00018
  18. Lutz BS, Wei FC, Chang SC et al : Donor site morbidity after suprafacial elevation of the radial forearm flap : a prospective study in 95 consecutive cases. Plast Reconstr Surg 103 : 132, 1999 https://doi.org/10.1097/00006534-199901000-00021
  19. Avery CME, Pereira J, Brown AE : Suprafascial dissection of the radial forearm and donor site morbidity. Int J Oral Maxillofacial Surg 30 : 37, 2001 https://doi.org/10.1054/ijom.2000.0016
  20. Sleeman D, Carton AT, Stassen LF : Closure of radial forearm free flap defect using full-thickness skin from the anterior abdominal wall. Br J Oral Maxillofac Surg 32 : 54, 1994 https://doi.org/10.1016/0266-4356(94)90176-7
  21. Gaukroger MC, Langdon JD, Whear NM et al : Repair of the radial forearm flap donor site with a full-thickness graft. Int J Oral Maxillofac Surg 23 : 205, 1994 https://doi.org/10.1016/S0901-5027(05)80371-6
  22. Fenton O, Roberts J : Improving the donor site of the radial forearm flap. Br J Plast Surg 38 : 504, 1985 https://doi.org/10.1016/0007-1226(85)90009-8
  23. Wax MK, Winslow CP, Andersen PE : Use of alloderm for coverage of radial forearm flap donor site coverage. J Otolaryngol 31 : 341, 1999 https://doi.org/10.2310/7070.2002.34423
  24. Sinha UK, Shih C, Chang K et al : Use of alloderm for coverage of radial forearm free flap donor site. Laryngoscope 112 : 230, 2002 https://doi.org/10.1097/00005537-200202000-00006
  25. Koide M, Osaki K, Konishi J et al : A new type of biomaterial for artificial skin : dehydrothermally cross-linked composites of fibrillar and denatured collagen. J Biomed Mater Res 27 : 79, 1986
  26. Lee JW, Jang YC, Oh SJ : Use of the artificial dermis of free radial forearm flap donor site. Ann Plast Surg 55 : 500, 2005 https://doi.org/10.1097/01.sap.0000183789.00146.c6