OBJECTIVE: To determine which method of fascial dissection and skin graft reconstruction of radial forearm free flap defects has superior functional and cosmetic outcomes. METHODS: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. RESULTS: 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. CONCLUSION:Suprafascial dissection with sheet graft reconstruction should be offered to patients requiring radial forearm free flap reconstruction of major head and neck defects.
RCT Entities:
OBJECTIVE: To determine which method of fascial dissection and skin graft reconstruction of radial forearm free flap defects has superior functional and cosmetic outcomes. METHODS: 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. RESULTS: 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. CONCLUSION: Suprafascial dissection with sheet graft reconstruction should be offered to patients requiring radial forearm free flap reconstruction of major head and neck defects.
Authors: Denys J Loeffelbein; Sammy Al-Benna; Lars Steinsträßer; Robin M Satanovskij; Nils H Rohleder; Thomas Mücke; Klaus-Dietrich Wolff; Marco R Kesting Journal: Eplasty Date: 2012-02-03
Authors: Vincent L Biron; Daniel A O'Connell; Brittany Barber; Jessica M Clark; Colin Andrews; Caroline C Jeffery; David W J Côté; Jeffrey Harris; Hadi Seikaly Journal: J Otolaryngol Head Neck Surg Date: 2017-03-14