title: [Cost effectiveness of a free forearm flap in reconstruction of the oral cavity and pharynx--the donor site complications].
abstract: OBJECTIVE
  Evaluation of the donor site efficiency in patients after reconstructive surgery with use of free forearm flap. All patients were treated for oral cavity and larynx cancer.
  
  
  METHODS
  a group of 21 patients (16 men and 5 women) treated in 2007-2011. The retrospective analysis was conducted on the anamnesis, operating protocols, physical examination and a questionnaire, there was completed by patients during a routine ENT follow up examination. The PRWE (Patient Rated Wrist Evaluation) subjective questionnaire was used to estimate the rate of pain severity and wrist mobility.
  
  
  RESULTS
  In 59% of patients the wrist was healed primary, in 36% of patients by granulation. In all patients the wound was healed satisfactory in follow up examination, but 60% of patients revealed extensive scars formation. 62% of patients showed no local pain at rest, while in 38% of them worsening of symptoms was noticed--average 0.5/10 (median 1.0). Pain was more intense in patients who did basic motor activity of hands approximately 1/10 and lifting weights averaging 2.1/10. Dysfunction of the wrist was at the level of the average value of 4.2/50.
  
  
  CONCLUSIONS
  Surgical reconstruction with a use of the free forearm flap is associated with the formation of extensive wrist scars. The risk of local complications is low while preserving the qualification protocol, postoperative care and proper surgical management. Reconstructive surgery based on the free forearm flaps gives satisfactory functional results of the donor site. However, it requires surgical experience and practical knowledge of anatomy.
authors.affiliation: Oddział Kliniczny Otolaryngologii i Onkologii Laryngologicznej Szpital Kliniczny, Poznań, Poland. maciejpabi@poczta.onet.pl
authors.forename: Maciej
authors.initials: M
authors.lastname: Pabiszczak
authors.forename: Jacek
authors.initials: J
authors.lastname: Banaszewski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Balcerowiak
authors.forename: Witold
authors.initials: W
authors.lastname: Szyfter
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000473:pathology; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000191:economics*; D006801:Humans; D008297:Male; D009055:Mouth / Q000601:surgery; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010614:Pharynx / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects* / Q000379:methods; D011795:Surveys and Questionnaires; D060053:Transplant Donor Site / Q000473:pathology / Q000503:physiopathology*; D014953:Wrist / Q000503:physiopathology*