Donor web site morbidity and high quality of life after microvascular head and neck reconstruction with free fibula and deep-circumflex iliac artery flaps.
J Craniomaxillofac Surg. 2017 Feb;45(2):304-311
Authors: Schardt C, Schmid A, Bodem J, Krisam J, Hoffmann J, Mertens C
PURPOSE: Bone defects after resective tumor surgical procedures typically require using microvascular reanastomized bone grafts for reconstruction. The choice as to which particular flap is most fitted for the actual affected person depends on numerous elements. The points donor web site morbidity and high quality of life are not often taken under consideration on this connection. The intention of this research was to research whether or not these elements, sooner or later, ought to affect the selection of donor web site.
MATERIAL AND METHODS: On this research, the donor websites of 46 sufferers with respect to deep-circumflex iliac artery (DCIA) and fibula flaps had been analyzed utilizing subjective and goal parameters. The first consequence was postoperative ache measured by VAS. Postoperative complication evaluations in addition to 2 orthopedic scores had been applied (American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Rating and Harris Hip Rating) and the sufferers’ high quality of life was assessed utilizing the 36-Merchandise Brief Kind (SF-36) questionnaire to quantify donor web site impairment.
RESULTS: Postoperative ache was rated with a imply worth of 42.four mm (SD 34.eight) for the DCIA group and 36.9 mm (SD 37.1) for the fibula group (p = zero.617). After a imply interval of 13.72 months, ache was rated with a imply worth of 15.three mm (SD 21.7) for DCIA and 13.three mm (SD 22.6 mm) for the fibula (p = zero.763). Persistent ache, nevertheless, was recorded solely in 11.11% of DCIA sufferers and 5.26% of fibula sufferers. Moreover ache depth was greater within the DCIA group. A modified gait sample was noticed in 59.26% of DCIA sufferers and 21.05% of fibula sufferers. DCIA sufferers required strolling aids for strolling and stair climbing extra typically. Wanting on the outcomes of the two orthopedic scores, fibula sufferers confirmed barely higher outcomes. Regarding high quality of life, sufferers after reconstructive surgical procedure with DCIA flaps confirmed slight higher outcomes than sufferers within the fibula group.
CONCLUSIONS: Taking the outcomes of this research under consideration, the end result when it comes to ache, morbidity and high quality of life didn’t present a major superiority of any donor web site.
PMID: 28007392 [PubMed – indexed for MEDLINE]