Abstract
The radial flap may be raised using a subfascial or suprafascial approach. The latter
donor site is associated with fewer healing complications. We retrospectively evaluated
the quality of sensory recovery within two comparable groups of 30 patients with subfascial
and suprafascial donor sites. When considering the two groups, two-point discrimination
was the modality most commonly reduced, with 97% of patients in both groups having
reduced sensation in at least one anatomical zone. Sensation of sharp touch was most
often lost; 90% in the subfascial and 83% in the suprafascial groups lost sensation
in at least one anatomical zone. Roughly half the patients had reduced perception
of light touch (43% and 50%), whilst perception of heat (27% and 17%) and cold (33%
and 27%) were lost least often. At least one modality in at least one anatomical zone
was lost or reduced in all patients, and roughly two-thirds (73% and 63%) had a reduction
in 3 or more. The only significant difference between the donor and non-donor arms
was reduced perception of sharp touch in the anterior forearm in both groups (p < 0.001). Perception at the two sites (including the anatomical snuff box) was similar
except for superior thenar palmar light touch (p = 0.015) in the suprafascial group, which may indicate injury to the thenar cutaneous
sensory branches during subfascial dissection.
Keywords
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References
- Review of the radial free flap: is it still evolving, or is it facing extinction? Part one: soft-tissue radial flap.Br J Oral Maxillofac Surg. 2010; 48: 245-252
- Radial forearm flap donor-site complications and morbidity: a prospective study.Plast Reconstr Surg. 1997; 99: 109-115
- Reducing morbidity in the radial forearm flap donor site.Plast Reconstr Surg. 1990; 86: 287-294
- Sensory deficit in the donor hand after harvest of radial forearm free flaps.Br J Oral Maxillofac Surg. 2006; 44: 100-102
- Limiting donor site morbidity by suprafascial dissection of the radial forearm flap.Microsurgery. 1996; 17: 136-140
- Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases.Plast Reconstr Surg. 1999; 103: 132-137
- Prospective study of the septocutaneous radial free flap and suprafascial donor site.Br J Oral Maxillofac Surg. 2007; 45: 611-616
- Radial forearm donor site: comparison of the functional and cosmetic outcomes of different reconstructive methods.J Otolaryngol Head Neck Surg. 2009; 38: 294-301
- Repair of radial free flap donor site by full-thickness skin graft from inner arm.Br J Oral Maxillofac Surg. 2005; 43: 161-165
- Complications of radial forearm flap donor sites.Br J Plast Surg. 1986; 39: 176-178
- Morbidity in the forearm flap donor arm.Br J Plast Surg. 1987; 40: 207-212
- The radial forearm flap: reconstructive applications and donor-site defects in 35 consecutive patients.Plast Reconstr Surg. 1990; 85: 258-266
- The radial forearm free flap in orofacial reconstruction. Personal experience in 120 consecutive cases.J Craniomaxillofac Surg. 1990; 18: 2-7
- Aesthetic and functional results of harvesting radial forearm flap, especially with regard to hand function.Int J Oral Maxillofac Surg. 2001; 30: 42-48
- Sensory recovery in noninnervated flaps used for oral cavity and oropharyngeal reconstruction.Arch Otolaryngol Head Neck Surg. 1995; 121: 967-972
- Recovery of sensation in the skin of non-innervated radial flaps after subfascial and suprafascial dissection.Br J Oral Maxillofac Surg. 2006; 44: 213-216
- An anatomical study of the palmar cutaneous branch of the median nerve.Surg Radiol Anat. 1986; 8: 183-188
- Palmar cutaneous branch of the median nerve.J Hand Surg Am. 1990; 15: 38-43
- Reinnervation of human skin grafts: a histochemical study.Plast Reconstr Surg. 1983; 72: 439-447
Article info
Publication history
Published online: November 14, 2011
Accepted:
October 20,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
