Assessment of post‐surgical donor‐site morbidity in vastus lateralis free flap for head and neck reconstructive surgery: an observational study. Issue 12 (3rd September 2021)

• Record Type: Journal Article
• Authors: Seth, Ishith; Hewitt, Lyndel; Yabe, Takako; Dunn, Masako; Wykes, James; Clark, Jonathan R.; Ashford, Bruce
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 12(2021)
• Page Start: 2738
• Page End: 2743
• Publication Date: 2021-09-03
• Subjects: donor‐site -- morbidity -- head and neck -- morbidity -- surgery -- vastus lateralis; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.17187
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor‐site morbidity is not well described. This study aimed to assess donor‐site morbidity after VL flap harvest. Results will determine future directions for preventative and post‐operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor‐site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length and tactile sensation), quality of life (SF‐12), lower extremity function, gait (function and speed) and sit to stand were assessed using validated and standardized procedures. The outcomes were compared to age‐matched healthy reference values or to the non‐operative side. Analyses were conducted using descriptive statistics and non‐parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit‐to‐stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non‐operated leg ( P = 0.02) and walking speed was slower than age‐matched healthy values ( P < 0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF‐12 ( P < 0.001). The mental health component of the SF‐12 was similar to healthy controls ( P = 0.256). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit‐to‐stand and muscle length. VL harvest affected donor‐site knee flexion strength, walking speed, tactile sensation and physical health‐related quality of life. Abstract : Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, the donor‐site morbidity is not well described. Participants (mean age 55 years) were assessed for the presence of donor‐site morbidity after VL harvest. There was no difference in muscle strength (knee extension), muscle length, ability to sit‐to‐stand or gait function (all P > 0.05). Thigh tactile sensation was impaired in 89% of participants and quality of life was significantly less for the physical health component of the SF‐12 ( P < 0.001). Donor site morbidity of VL harvest is minor.