Short-term functional donor site morbidity after radial forearm fasciocutaneous free flap harvest.
OBJECTIVE
The existing literature on postoperative donor extremity function describes a spectrum of morbidity in the long term (>3 mo after surgery). However, the consensus is that there is minimal to no impact of flap harvest on patients' activities of daily living. No previous reports have examined functional donor site morbidity in the early postoperative period; such may affect patients' overall perioperative progress, especially with respect to donor extremity dominance. The authors' objective was to quantify functional morbidity of the donor site in radial forearm fasciocutaneous free flaps during the early postoperative period.


METHODS
Retrospective case series review.


METHODS
Patient data were obtained from hospital records of 12 consecutive patients who underwent head and neck reconstruction with radial forearm fasciocutaneous free tissue transfer over a 6-month period at a tertiary academic medical center. Functional results of each patient's donor extremity obtained preoperatively and at 5 to 8 days after surgery were determined by quantifying forearm supination and pronation, wrist flexion and extension, and sharp and dull hand sensations in radial, median, and ulnar nerve distributions.


RESULTS
Mean patient age was 57 years (age range, 42-71 y). The nondominant extremity was the donor site in 9 of 12 patients. Using the paired two-tailed t test, statistically significant differences were demonstrated in preoperative versus postoperative forearm supination (P <.032), pronation (P <.006), wrist flexion (P <.000), and wrist extension (P <.000). Three of 12 patients demonstrated diminished sharp sensation in the "anatomical snuffbox" distribution.


CONCLUSIONS
The authors describe statistically significant functional forearm and wrist range-of-motion morbidity associated with the harvest of a radial forearm fasciocutaneous free flap in the early postoperative period.
Skoner
Judith M
JM
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road PV01, Portland, OR 97239-3098, USA.
Bascom
Daphne A
DA
Cohen
James I
JI
Andersen
Peter E
PE
Wax
Mark K
MK
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001132:Arm / Q000294:innervation; D005260:Female; D005542:Forearm / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011403:Pronation / Q000502:physiology; D016059:Range of Motion, Articular; D013484:Supination / Q000502:physiology; D013524:Surgical Flaps; D013997:Time Factors; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting; D014953:Wrist