title: Comparison of radial forearm flap and thoracodorsal artery perforator flap donor site morbidity for reconstruction of oral and oropharyngeal defects in head and neck cancer.
abstract: BACKGROUND
  Reconstruction of the oral cavity and oropharynx after tumour resection often involves the use of free flaps, but donor site morbidity must be taken into account. The radial forearm flap, the flap most commonly used in this setting, leaves a readily visible scar on an exposed region of the body. The thoracodorsal artery perforator flap (TDAP), which possesses the same plastic qualities as the radial forearm flap, leaves a scar that is hidden in the axilla. The purpose of this study was to evaluate the cosmetic results of radial forearm and thoracodorsal artery perforator free flap donor sites.
  
  
  METHODS
  The medical charts of all patients undergoing reconstruction by a radial forearm or thoracodorsal artery perforator free flap between January 2011 and December 2011 were retrospectively reviewed. The Patient and Observer Scar Assessment Scales and the Vancouver Scar Scale were used to evaluate the quality of the scars.
  
  
  RESULTS
  Reconstruction was performed by radial forearm flap in 4 cases and TDAP flap in 7 cases. The PSAS score was significantly lower in the TDAP group than in the radial forearm group (P=0.03), and the OSAS score was higher in the radial forearm group (21.5 versus 14). The Vancouver Scar Scale was significantly higher for radial forearm flap scars than for TDAP scars (8 versus 2.7, P=0.005).
  
  
  CONCLUSIONS
  This is the first study to compare radial forearm and thoracodorsal artery perforator free flap donor site scars. It demonstrates the minimal TDAP donor site morbidity and the high level of patient satisfaction.
authors.affiliation: Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Unité de recherche clinique, hôpital Foch, 40, rue Worth, 92150 Suresnes, France. Electronic address: christine.bach@hopital-foch.org.
authors.forename: C A
authors.initials: CA
authors.lastname: Bach
authors.affiliation: Unité de recherche clinique, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Dreyfus
authors.affiliation: Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
authors.forename: I
authors.initials: I
authors.lastname: Wagner
authors.affiliation: Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
authors.forename: X
authors.initials: X
authors.lastname: Lachiver
authors.affiliation: Service de radiologie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
authors.forename: A
authors.initials: A
authors.lastname: Guth
authors.affiliation: Service de chirurgie ORL et cervico-faciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Université Versailles - Saint-Quentin-en-Yvelines, UFR de médecine Paris-Ouest - Saint-Quentin-en-Yvelines, 78280 Guyancourt, France.
authors.forename: F
authors.initials: F
authors.lastname: Chabolle
mesh_terms: D000368:Aged; D004954:Esthetics; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D061525:Perforator Flap; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D060053:Transplant Donor Site; D014945:Wound Healing
keywords: Donor site morbidity; Head and neck cancer; Radial forearm flap; Thoracodorsal artery perforator flap