Comparison of Radial Forearm Free‐Flap Donor Site Dressing Modalities with Temporary Forearm Immobilization. (23rd August 2013)

• Record Type: Journal Article
• Authors: Rangarajan, Sanjeet V.; Melon, David E.; Old, Matthew O.; Teknos, Theodoros N.; Agrawal, Amit; Ozer, Enver; Chio, Eugene G.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P58
• Page End: P59
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a78
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: 1) Compare the success and complication rates of two dressing techniques for radial forearm free‐flap donor sites in patients undergoing short term limb immobilization. 2) Recognize the observed benefit of short‐term donor limb immobilization in this population. Methods: This was a prospective, randomized, controlled study of patients undergoing radial forearm free flap reconstruction of head and neck oncologic post‐ablative defects from 2010 to 2013 at a single tertiary care center. Participants' donor sites were covered with split‐thickness skin grafts and were randomized into two arms: static pressure dressing and negative pressure dressing groups. All participants underwent immobilization of the donor arm using a custom‐fit removable volar splint for 30 days. Data were collected at 2 postoperative time points. Results: Fifty‐four patients underwent radial forearm and were enrolled in the study. Twenty‐seven patients (50%) received negative pressure dressings, and 27 patients (50%) received static pressure dressings. 100% of enrolled patients were immobilized with custom volar splints. Follow‐up data were available for 40 (74%) patients at the time of this writing. The overall complication rate was 20% (n = 8). Within the group of patients with medical co‐morbidities, 25% (n = 2) demonstrated donor site morbidity. Conclusions: This study reaffirms both techniques as viable methods for covering radial forearm donor sites; however, there are differences between them in cost and convenience for the patient. Additionally, this follow‐up study demonstrates that 30‐day immobilization may improve donor site outcome regardless of dressing strategy, as evidenced by an overall decrease in donor site morbidity compared to previously published results on non‐immobilized patients.