Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Surgical outcomes of suprafascial and subfascial radial forearm free flaps in head and neck reconstruction

  • Sae Hwi Ki (Department of Plastic and Reconstructive Surgery, Inha University Hospital) ;
  • Tae Jun Park (Department of Plastic and Reconstructive Surgery, Inha University Hospital) ;
  • Jin Myung Yoon (Department of Plastic and Reconstructive Surgery, Inha University Hospital)
  • Received : 2023.04.06
  • Accepted : 2023.06.19
  • Published : 2023.06.20
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Abstract

Background: Conventional radial forearm free flaps (RFFFs) are known to be safe, but can result in donor site complications. Based on our experiences with suprafascial and subfascial RFFFs, we evaluated the safety of flap survival and surgical outcomes. Methods: This was a retrospective study of head and neck reconstructions using RFFFs from 2006 to 2021. Thirty-two patients underwent procedures using either subfascial (group A) or suprafascial (group B) dissection for flap elevation. Data were collected on patient characteristics, flap size, and donor and recipient complications, and the two groups were compared. Results: Thirteen of the 32 patients were in group A and 19 were in group B. Group A included 10 men and three women, with a mean age of 56.15 years, and group B included 16 men and three women, with a mean age of 59.11 years. The mean defect areas were 42.83 cm2 and 33.32 cm2, and the mean flap sizes were 50.96 cm2 and 44.54 cm2 in groups A and B, respectively. There were 13 donor site complications: eight (61.5%) in group A and five (26.3%) in group B. Flexor tendon exposure occurred in three patients in group A and in none in group B. All flaps survived completely. A recipient site complication occurred in two patients (15.4%) in group A and three patients (15.8%) in group B. Conclusions: Complications and flap survival were similar between the two groups. However, tendon exposure at the donor site was less prevalent in the suprafascial group, and the treatment period was shorter. Based on our data, suprafascial RFFF is a reliable and safe procedure for reconstruction of the head and neck.

Keywords

Acknowledgement

The statistical data used in this paper were supported by the Biostatistics Center of Inha University Hospital, Incheon, South Korea.

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