Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes

Hunger, Stefan; Postl, Lukas; Stehrer, Raphael; Hingsammer, Lukas; Krennmair, Stefan; Feistl, Wolfgang; Malek, Michael und Krennmair, Gerald (2020): Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes. In: Clinical Oral Investigations, Bd. 24, Nr. 7: S. 2433-2443

Abstract

Objective: To evaluate the clinical, functional and aesthetic outcomes for radial forearm free flap (RFFF) donor sites covered with amniotic membrane (AM). Material and methods: The healing process of patients with RFFF donor sites covered with AM was prospectively followed for 1 year. Additionally at the 12-month evaluation, objective scoring systems were used to assess the aesthetic (Vancouver scar scale, VSS: range 1-13) and functional outcome (skin sensibility, hand/wrist functionality [goniometer], grip strength [score 1 = excellent, 5 = poor]). By using a subjective rating system (score 1 = excellent, 5 = poor), the patient-reported aesthetic and functionality outcome was correlated with objective data analysis. Results: Twenty-one out of 23 patients were followed for 12 months (dropout: 2 patients at 3 months). In 17/23 (73.9%) patients RFFF defect covered with AM showed an uneventful healing period (< 3 months). Prolonged healing periods (> 3 months < 6) for 6 patients (26.1%) were attributed to wound infections (4x), seroma (1x) and inflammation (1x). At the 1-year evaluation, there was a significant (p < 0.01) correlation between subjective (2.0 +/- 0.71) and objective aesthetic scores (VVS 3.74 +/- 2.18), and a successful grip strength (score 1.67 +/- 0.86);however, thumb hyposensibility in 76.2% was seen. A high body mass index (BMI) was in conjunction with a negative (p = 0.012) and the use of antihypertensive medications provided positive effects (p = 0.041) on the aesthetic outcome. Conclusion RFFF donor site defects covered using AM show excellent clinical, aesthetic and functional outcome representing patient comorbidities (BMI, antihypertensive drugs) might affect the aesthetic outcome.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1432-6981
• Sprache: Englisch