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01.05.2024 | Research

Medial sural artery perforator free flap versus radial forearm free flap in oral cavity reconstruction and donor site morbidity

verfasst von: Abdo Ahmed Saleh Mohamed, Lianxi Mai, Mubarak Ahmed Mashrah, Song Fan, Shuang Wang, Zhaoyu Lin, Chaobin Pan

Erschienen in: Clinical Oral Investigations | Ausgabe 5/2024

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Abstract

Objective

Radial Forearm Free flap (RFFF) is widely used in head and neck reconstruction, yet its donor site defect remains a significant drawback. The Medial Sural Artery Perforator Free Flap (MSAPFF) is considered an alternative flap to RFFF. This study aims to comprehensively analyze their characteristics, outcomes, and their impact on patient quality of life.

Methods

All patients who underwent oral cavity reconstruction using RFFF and MSAPFF between February 2017 and April 2023 were included in this study. Flap characteristics, outcomes and post-operative complications were recorded and compared. Subjective donor site morbidity, aesthetic and functional results, and quality of life were also analyzed.

Results

The study included 76 patients: 37 underwent reconstruction with RFFF, and 39 with MSAPFF. There was no significance difference between the RFFF and MSAPFF regarding the success rate (97.2% vs 97.4%), flap size (4.8 × 8.8 cm² vs 5 × 9.8 cm²), hospital of stay (15.5 days vs 13.5 days) and recipient site complications (P > 0.05). However, MSAPFF showed larger flap thickness (P = 0.001), smaller arterial caliber (P = 0.008), shorter pedicle length (P = 0.001), and longer harvesting time (P < 0.001). No significant difference was observed between the pre-and postoperative ranges of wrist and ankle movements or in recipient site complications. MSAPFF showed a significant difference in donor site morbidity (P < 0.05).

Conclusion

The MSAPFF is an excellent alternative to the RFFF for repairing oral cavity defects, with additional advantage of a well-hidden scar on the posterior calf, a larger flap thickness, accepted pedicle length and arterial caliber. However, one should consider the harvesting time and surgical skills required in comparison to the RFFF.

Clinical relevance

The study highlights the importance of the MSAPFF as an alternative option for RFFF with less donor site morbidity and high success rate in oral cavity reconstruction and improved patient Quality of life after ablative surgery.

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Titel: Medial sural artery perforator free flap versus radial forearm free flap in oral cavity reconstruction and donor site morbidity
verfasst von: Abdo Ahmed Saleh Mohamed
Lianxi Mai
Mubarak Ahmed Mashrah
Song Fan
Shuang Wang
Zhaoyu Lin
Chaobin Pan
Publikationsdatum: 01.05.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 5/2024
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-024-05618-1

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Medial sural artery perforator free flap versus radial forearm free flap in oral cavity reconstruction and donor site morbidity