TY - JOUR
T1 - A prospective cohort study of fibula free flap donor-site morbidity in 157 consecutive patients
AU - Momoh, Adeyiza O.
AU - Yu, Peirong
AU - Skoracki, Roman J.
AU - Liu, Suyu
AU - Feng, Lei
AU - Hanasono, Matthew M.
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/9
Y1 - 2011/9
N2 - Background: Although the fibula free flap is preferred for bony head and neck reconstruction, donor-site morbidity remains a concern. The authors goal was to evaluate potential risk factors for complications and whether the type of wound closure and timing of postoperative ambulation had an effect on the development of short-and long-term morbidities. Methods: A prospective cohort study of donor-site morbidity was performed in 157 consecutive patients who underwent fibula free flap reconstruction for head and neck defects. Results: Perioperative donor-site complications occurred in 31.2 percent of patients, including skin graft loss (15 percent), cellulitis (10 percent), wound dehiscence (8 percent), and abscess (1 percent). Preoperative chemotherapy (p = 0.02) was associated with increased complications. No significant difference in complication rates was observed between primary and skin graft wound closure (p = 0.59). The timing of ambulation was not related to the development of complications (p = 0.41). Long-term morbidities occurred in 17 percent of patients and included leg weakness (8 percent), ankle instability (4 percent), great toe contracture (9 percent), and decreased ankle mobility (12 percent). The occurrence of perioperative complications, flap type, and closure technique were not significantly associated with long-term morbidities. Functionally, 96 percent of patients returned to their preoperative level of ambulatory activity. Decreases in ambulatory status could all be ascribed to causes other than donor-site morbidity. Conclusion: Fibula free flap harvest is associated with a high rate of complications, but the majority of patients have no long-term functional limitations.
AB - Background: Although the fibula free flap is preferred for bony head and neck reconstruction, donor-site morbidity remains a concern. The authors goal was to evaluate potential risk factors for complications and whether the type of wound closure and timing of postoperative ambulation had an effect on the development of short-and long-term morbidities. Methods: A prospective cohort study of donor-site morbidity was performed in 157 consecutive patients who underwent fibula free flap reconstruction for head and neck defects. Results: Perioperative donor-site complications occurred in 31.2 percent of patients, including skin graft loss (15 percent), cellulitis (10 percent), wound dehiscence (8 percent), and abscess (1 percent). Preoperative chemotherapy (p = 0.02) was associated with increased complications. No significant difference in complication rates was observed between primary and skin graft wound closure (p = 0.59). The timing of ambulation was not related to the development of complications (p = 0.41). Long-term morbidities occurred in 17 percent of patients and included leg weakness (8 percent), ankle instability (4 percent), great toe contracture (9 percent), and decreased ankle mobility (12 percent). The occurrence of perioperative complications, flap type, and closure technique were not significantly associated with long-term morbidities. Functionally, 96 percent of patients returned to their preoperative level of ambulatory activity. Decreases in ambulatory status could all be ascribed to causes other than donor-site morbidity. Conclusion: Fibula free flap harvest is associated with a high rate of complications, but the majority of patients have no long-term functional limitations.
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U2 - 10.1097/PRS.0b013e318221dc2a
DO - 10.1097/PRS.0b013e318221dc2a
M3 - Article
C2 - 21572380
AN - SCOPUS:80052463839
SN - 0032-1052
VL - 128
SP - 714
EP - 720
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 3
ER -