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Double-layered collagen graft to the radial forearm free flap donor sites without skin graft.

Park TJ, Kim HJ, Ahn KM - Maxillofac Plast Reconstr Surg (2015)

Bottom Line: All patients were satisfied with the esthetic results.Double-layered collagen graft was successfully performed in this study.Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ulsan, Seoul Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, 138-736 Seoul South Korea.

ABSTRACT

Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft.

Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated.

Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer.

Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

No MeSH data available.


Related in: MedlinePlus

Tendon exposure case: during operation
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Fig17: Tendon exposure case: during operation

Mentions: Donor site complications including graft rejection, graft failure, infection, impaired hand manipulation, and swelling of hand were not noted in any patient. There was no functional defect or impairment 3 months after operation. One patient had suffered from tendon exposure at follow-up visit 2 months from surgery. The other 21 patients were satisfied with the esthetic results. Three patients died of recurred buccal mucosa cancer 17, 22, and 30 months after operation, respectively (patient nos. 2, 13, and 15 in Table 1). During the healing period, epithelial migration was over the artificial dermis graft from the adjacent normal skin toward the center of the donor site defect. The original donor defect were ranged from 20 to 48 cm2, and the mean defect size was 31 cm2 (Table 1). The final scar sizes were ranged from 3.3 to 19.8 cm2 except one case of tendon exposure patient. The mean of final scar size was 11.6 cm2. The original donor defect of the tendon exposure case was 42 cm2, but 2 months later, the scar size was measured to 40.5 cm2 approximately. On average, the final scar area was decreased to 36.1 % size in average compared to the original donor defects. The complete healing was obtained between 1.5 and 3 months according to the defect size in 21 patients (Figs. 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and 16). The scar areas of the most patients were not changed markedly and remained stable after the 3 months from the surgery. Tendon exposure was observed in one patient in 22 patients. He suffered some donor site discomfort functionally and esthetically. Prolonged treatment including periodical follow-up and wound dressing was done until complete wound healing was conformed after 11 months postoperatively (Figs. 17, 18, and 19).Table 1


Double-layered collagen graft to the radial forearm free flap donor sites without skin graft.

Park TJ, Kim HJ, Ahn KM - Maxillofac Plast Reconstr Surg (2015)

Tendon exposure case: during operation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4666235&req=5

Fig17: Tendon exposure case: during operation
Mentions: Donor site complications including graft rejection, graft failure, infection, impaired hand manipulation, and swelling of hand were not noted in any patient. There was no functional defect or impairment 3 months after operation. One patient had suffered from tendon exposure at follow-up visit 2 months from surgery. The other 21 patients were satisfied with the esthetic results. Three patients died of recurred buccal mucosa cancer 17, 22, and 30 months after operation, respectively (patient nos. 2, 13, and 15 in Table 1). During the healing period, epithelial migration was over the artificial dermis graft from the adjacent normal skin toward the center of the donor site defect. The original donor defect were ranged from 20 to 48 cm2, and the mean defect size was 31 cm2 (Table 1). The final scar sizes were ranged from 3.3 to 19.8 cm2 except one case of tendon exposure patient. The mean of final scar size was 11.6 cm2. The original donor defect of the tendon exposure case was 42 cm2, but 2 months later, the scar size was measured to 40.5 cm2 approximately. On average, the final scar area was decreased to 36.1 % size in average compared to the original donor defects. The complete healing was obtained between 1.5 and 3 months according to the defect size in 21 patients (Figs. 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, and 16). The scar areas of the most patients were not changed markedly and remained stable after the 3 months from the surgery. Tendon exposure was observed in one patient in 22 patients. He suffered some donor site discomfort functionally and esthetically. Prolonged treatment including periodical follow-up and wound dressing was done until complete wound healing was conformed after 11 months postoperatively (Figs. 17, 18, and 19).Table 1

Bottom Line: All patients were satisfied with the esthetic results.Double-layered collagen graft was successfully performed in this study.Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ulsan, Seoul Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, 138-736 Seoul South Korea.

ABSTRACT

Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of double-layered collagen graft to the donor site of the forearm free flap without skin graft.

Methods: Twenty-two consecutive patients who underwent oral cancer ablation and forearm reconstruction between April 2010 and November 2013 were included in this study. Male to female ratio was 12:10, and average age was 61.0 years old (27-84). Double-layered collagen was grafted to the donor site of the forearm free flap and healed for secondary intention. Upper silicone had been trimmed at the periphery during secondary intention, and dry dressing was used. Postoperative scar healing and esthetic results and function were evaluated.

Results: An average follow-up period was 34.9 months. The scar area was decreased to 63.9 % in average. The complete healing was obtained between 1.5 and 3 months according to the defect size. There was no functional defect or impairment 3 months after operation. All patients were satisfied with the esthetic results. Three patients died of recurred cancer.

Conclusions: Double-layered collagen graft was successfully performed in this study. Without the thigh skin graft, patients had experienced less painful postoperative healing periods and discomfort.

No MeSH data available.


Related in: MedlinePlus