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An algorithm to improve outcomes of radial forearm flap donor site |
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| Authors: | Salvatore D’arpa Walter Mazzucco Matteo Rossi Sergio Mazzola Francesco Moschella |
| Institution: | 1. Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy;2. Deparment of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium;3. Cancer Registry of Palermo and Province Department for Health Promotion Science and Mother and Child, “G. D’Alessandro”, University of Palermo, Palermo, Italy;4. Cancer Registry of Palermo and Province Clinical Epidemiology and Cancer Registry Operative Unit, University Hospital Policlinico “Paolo Giaccone”, Palermo, Italy |
| Abstract: | Background: Due to the high rate of donor site complications the Radial Forearm Flap (RFF) has lost ground in favor of the Antero-lateral tight flap (ALT) and other flaps. We have designed a reconstruction algorithm for reconstruction of its donor site. The goal of this study was to retrospectively evaluate the impact of this algorithm on RFF donor site complication rates. Methods: The authors analyzed retrospectively 31 patients who underwent free radial forearm flap reconstruction between November 2009 and May 2013. Donor site complications were compared with data from patients treated before introdutction of the algorithm. Within the group were compared patients in which the flap was harvested suprafascial with those in which the flap was harvested as subfascial. Results: Before application of the algorithm, there was a 23.3% complication rate at the RFF donor site, in our experience. After introduction of the algorithm, complication rate has dropped to 3.2%, consisting in a partial skin graft necrosis treated by local wound-care and healed without further intervention. Conclusions: Application of the algorithm described has led to a significant reduction in RFF donor site complication rates. This demonstrates that if flap donor sites are analyzed and tailor treated in the same way as primary defects are, instead of being given secondary importance and just grafted, outcomes improve. |
| Keywords: | Radial free flap suprafascial dissection radial free flap donor site |