Posterior tibial artery flap versus radial forearm flap in oral cavity reconstruction and donor site morbidity |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;2. Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangdong, Guangzhou, China;1. Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan;2. Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan;3. Department of Oral and Maxillofacial Surgery, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan;1. School of Medicine, University of Queensland, Herston, Australia;2. Department of Maxillofacial Surgery, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia;1. Harvard School of Dental Medicine, Boston, Massachusetts, USA;2. Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA, USA;3. Program in Global Surgery and Social Change (PGSSC), Harvard Medical School, Boston, MA, USA;1. Department of Stomatology, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, PR China;2. Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, PR China;1. Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital Birmingham, UK;2. Restorative Department, Birmingham Dental Hospital, Birmingham, UK;1. Boston Children’s Hospital, Boston, Massachusetts, USA;2. Harvard School of Dental Medicine, Boston, Massachusetts, USA;3. Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts, USA;4. Division of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, Massachusetts, USA;5. Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, Massachusetts, USA |
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| Abstract: | The repair of soft tissue defects after oral cavity cancer resection is challenging. The aim of this study was to compare the outcomes and donor site morbidity of the radial forearm free flap (RFF) and posterior tibial artery perforator flap (PTAF) for oral cavity reconstruction after cancer ablation. All patients who underwent oral cavity reconstruction with a RFF or PTAF between January 2017 and December 2019 were included retrospectively in this study. All flaps were harvested with a long adipofascial extension. The donor site defects were closed with a triangular full-thickness skin graft harvested adjacent to the flap. Flap outcomes and donor site complications were recorded and compared. The study included 145 patients; 30 underwent reconstruction with a RFF and 115 with a PTAF. No significant difference between the PTAF and RFF was observed concerning the flap survival rate (98.3% vs 96.7%), flap harvest time (53.39 vs 49.28 min), hospital stay (12.3 vs 15.2 days), or subjective functional and cosmetic outcomes. The PTAF showed a larger vascular calibre (P < 0.05), greater flap thickness (P = 0.002), and lower frequency of surgical site infection (P = 0.055) when compared to the RFF. No significant difference was observed between the pre- and postoperative ranges of ankle and wrist movements. The PTAF is an excellent alternative to the RFF for the repair of oral cavity defects, with the additional advantages of a well-hidden scar on the lower extremity, larger vascular calibre, and lower frequencies of postoperative donor site morbidities. |
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| Keywords: | Radial artery Free tissue flaps Tibial arteries Oral cavity Reconstructive surgical procedures |
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