Short-Term Functional Donor Site Morbidity after Radial Forearm Fasciocutaneous Free Flap Harvest

Judith M. Skoner, Daphne A. Bascom, James Cohen, Peter Andersen, Mark Wax

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Objectives/Hypothesis: 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. Study Design: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)2091-2094
Number of pages4
JournalLaryngoscope
Volume113
Issue number12
DOIs
Publication statusPublished - Dec 2003

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Keywords

  • Donor site morbidity
  • Free flap
  • Postoperative complications
  • Radial forearm

ASJC Scopus subject areas

  • Otorhinolaryngology

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