Donor-site morbidity after harvesting of radial forearm free flaps—comparison of vacuum-assisted closure with conventional wound care: A randomized controlled trial
| Autor: | Dirk Halama, Niels Christian Pausch, Alexander K. Bartella, Bernd Lethaus, Ruth Dreilich |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Wrist Free Tissue Flaps law.invention 03 medical and health sciences Wound care Grip strength Postoperative Complications 0302 clinical medicine Randomized controlled trial Forearm law Negative-pressure wound therapy Statistical significance medicine Humans Prospective Studies Aged Wound Healing business.industry Skin Transplantation 030206 dentistry Middle Aged Surgery Tendon Treatment Outcome medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Tissue and Organ Harvesting Female Oral Surgery business Negative-Pressure Wound Therapy |
| Zdroj: | Journal of Cranio-Maxillofacial Surgery. 47:1980-1985 |
| ISSN: | 1010-5182 |
| Popis: | Introduction Radial forearm free flaps (RFFF) are often used to replace tissue removed in head and neck surgery. In recent years, many attempts have been made to reduce donor-site morbidity and to prevent common complications such as infection, skin-graft necrosis, tendon exposure and subsequent impairment of hand function. One promising option is the use of vacuum-assisted-closure wound therapy (VAC). The objective of this study was to evaluate the effectiveness of VAC compared with a conventional bolster dressing (CBD). Material and methods A randomized controlled trial was enrolled. Our study was prospective in design and included patients with a skin-grafted forearm defect after harvesting of RFFF. Patients who met the inclusion criteria were randomly assigned into two study arms. The predictor variable was the type of wound therapy (VAC therapy compared with CBD) and the outcome variables were (1) the size of the wound area, (2) wrist movement and (3) grip strength. Outcome variables were assessed 12 days, three weeks and eight weeks after surgery. Results Fifty patients (33 males, mean age 61.7 years [SD 15.5]; 17 females, mean age 54.7 years [SD 10.5]) were included consecutively in the study. Patients in the VAC group experienced a faster postsurgical reduction of wound area and had better wrist movement; nonetheless, the differences between the VAC group and CBD group did not reach statistical significance. In contrast, the recovery of postsurgical grip strength was significantly faster in the VAC group. Conclusions Our study failed to prove that VAC therapy is significantly superior to CBD for all the variable studied. Because VAC therapy has some positive effects, however, we recommend further development of this negative-pressure wound treatment, rather than the termination of its use. |
| Databáze: | OpenAIRE |
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