Prospective study of the septocutaneous radial free flap and suprafascial donor site.
This is a prospective study of 121 consecutive radial septocutaneous flaps harvested by one surgeon. There were 117 successful flaps (97%). The incidence of early return to theatre for potential problems with the flap or the neck wound was 12/121 (10%) and the flap salvage rate was 3/7 (43%). The incidence of three early wound healing complications at the suprafascial donor site were: loss of the skin graft (4%), tendon exposure (3%) and delayed healing (4%). A full-thickness skin graft, usually from the inner upper arm, was used to repair three-quarters of donor site defects. The median time to healing was significantly longer for partial thickness grafts (14 days compared with 10 days, p<0.001). The degree of contraction of the skin graft used to repair the radial defect was significantly less for full thickness than partial thickness grafts (median -21% compared with -33%, p=0.01). There was more relative contraction with larger grafts (p<0.001) and in older patients (p=0.01). The septocutaneous radial flap is reliable. The early morbidity at the suprafascial donor site is relatively low in comparison to that reported at the subfascial donor site.
Avery
C
C
University Hospitals of Leicester, United Kingdom. chrisavery@doctors.org.uk <chrisavery@doctors.org.uk>
D000367:Age Factors; D004210:Dissection / Q000379:methods; D005205:Fascia / Q000637:transplantation*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D016038:Skin Transplantation / Q000379:methods*; D040521:Subcutaneous Tissue / Q000601:surgery; D013524:Surgical Flaps / Q000145:classification; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013710:Tendons / Q000473:pathology; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology; D014945:Wound Healing / Q000502:physiology