Limits...
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

Design of the radial forearm free flap during operation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4666235&req=5

Fig1: Design of the radial forearm free flap during operation

Mentions: RFFF was elevated by subfascial plane under general anesthesia. After the elevation of RFFF, adjacent muscles covered exposed the brachioradialis tendon. A MatriDerm® (MedSkin Solution, Billerbeck, Germany) sheet on the bottom layer and a Terudermis® (Terumo Corporation, Tokyo, Japan) sheet on the surface layer fitted to the defect site. Double-layered collagens were fixed with 2-0 silk temporary sutures, and a tie-over dressing was applied. A wrist-around splint was performed for 1 week to stabilize the graft and to minimize wound contractures (Figs. 1, 2, 3, and 4). One week after surgery, tie-over dressing was removed and a patient had the 2-0 silk stitches taken out. The silicone layer of Terudermis was trimmed at the periphery during secondary intention healing period, and dry dressing with powdered medicine was applied.Fig. 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)

Design of the radial forearm free flap during operation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig1: Design of the radial forearm free flap during operation
Mentions: RFFF was elevated by subfascial plane under general anesthesia. After the elevation of RFFF, adjacent muscles covered exposed the brachioradialis tendon. A MatriDerm® (MedSkin Solution, Billerbeck, Germany) sheet on the bottom layer and a Terudermis® (Terumo Corporation, Tokyo, Japan) sheet on the surface layer fitted to the defect site. Double-layered collagens were fixed with 2-0 silk temporary sutures, and a tie-over dressing was applied. A wrist-around splint was performed for 1 week to stabilize the graft and to minimize wound contractures (Figs. 1, 2, 3, and 4). One week after surgery, tie-over dressing was removed and a patient had the 2-0 silk stitches taken out. The silicone layer of Terudermis was trimmed at the periphery during secondary intention healing period, and dry dressing with powdered medicine was applied.Fig. 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