Clinical and histological results of sensory recovery after radial foreann flap transfer.
The necessity of nerve anastomosis in an attempt to regain dermal sensitivity following pedicled or free-flap transfer has been the basis of many discussions. In our study, we investigated the degree of sensory recovery with emphasis on the different nerval qualities, on the radial forearm flap and correlated it to the histological and immunohistological findings. Nineteen patients with radial forearm free flap--five of whom underwent nerve anastomosis--were examined. The follow-up interval was 20.3 months (average) after surgical intervention. Histological examinations were performed on 13 of the 19 patients, in eight cases on one occasion and in five on more than one occasion. Seventeen patients experienced sensory recovery, whereby the degree and quality of dermal innervation varied. In comparison, the nerval reconstruction did not lead to any significant improvement. Based on our clinical results, we regard the nerve reconstruction during the radial forearm free flap transfer as unnecessary. To what extent this can be said for other flaps demands further investigation.
Vesper
M
M
Department of Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. mkg@uke.uni-hamburg.de
Heiland
M
M
Blake
F
F
Flinzberg
S
S
Schmelzle
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000032:analysis; D000714:Anastomosis, Surgical; D001706:Biopsy; D002648:Child; D004396:Coloring Agents; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D005542:Forearm / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000032:analysis; D011826:Radial Nerve / Q000473:pathology / Q000502:physiology / Q000637:transplantation; D020127:Recovery of Function; D009418:S100 Proteins / Q000032:analysis; D012677:Sensation / Q000502:physiology*; D013373:Substance P / Q000032:analysis; D013524:Surgical Flaps / Q000294:innervation / Q000502:physiology*
D004396:Coloring Agents; D016900:Neurofilament Proteins; D009418:S100 Proteins; D013373:Substance P; D000469:Alkaline Phosphatase