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Authors: Thiem, Daniel G. E.
Siegberg, Fabia
Römer, Paul
Blatt, Sebastian
Pabst, Andreas
Heimes, Diana
Al-Nawas, Bilal
Kämmerer, Peer W.
Title: Long-term donor site morbidity and flap perfusion following Radial versus Ulnar Forearm Free Flap : a randomized controlled prospective clinical trial
Online publication date: 19-Jan-2023
Year of first publication: 2022
Language: english
Abstract: This clinical prospective randomized controlled study aimed to investigate the differences between Radial (RFFF) and Ulnar (UFFF) Forearm Free Flap in terms of success, performance, and donor site morbidity. Thirty patients with reconstruction of the head and neck region were included. For the first time, this study assessed flap-perfusion characteristics, donor-site-wound-healing dynamics and hand perfusion using hyperspectral imaging. Further, subjective (Likert-scale, DASH-score) and objective (grip/pinch-strength) parameters of donor site morbidity were analysed. Postoperative follow-up was performed until 6 months after index surgery. With 100% of patients, RFFF and UFFF were equally successful. Compared to surrounding reference, UFFF revealed significant lower tissue oxygenation saturation (StO2) than RFFF. Compared with UFFF, blood flow in both the thenar and hypothenar region were significantly reduced 6 months following RFFF transfer. After four weeks, 27% more patients demonstrated impaired wound healing following RFFF transfer. After 6 months, epithelial-surface continuity was restored in all patients of both groups. After 6 months, overall rates of both subjective and objective donor site morbidity were comparable between RFFF and UFFF. RFFF and UFFF both demonstrate similar success rates and HSI-perfusion dynamics following transfer. After 4 weeks, wound-healing disorder appeared significantly more often in RFFF than in UFFF; however, they became equal after 6 months. RFFF and UFFF can be considered as mutual alternatives. Keywords: RFFF; UFFF; reconstruction; head and neck; hyperspectral imaging; HSI; randomized controlled prospective study; free flap; donor site morbidity
DDC: 610 Medizin
610 Medical sciences
Institution: Johannes Gutenberg-Universität Mainz
Department: FB 04 Medizin
Place: Mainz
Version: Published version
Publication type: Zeitschriftenaufsatz
Document type specification: Scientific article
License: CC BY
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Journal: Journal of Clinical Medicine
Pages or article number: 3601
Publisher: MDPI
Publisher place: Basel
Issue date: 2022
ISSN: 2077-0383
Publisher DOI: 10.3390/jcm11133601
Appears in collections:DFG-491381577-G

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