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Donor-site complications in vascularized bone flap surgery
Ed H M Hartman1, Paul H M Spauwen, John A Jansen
1Department of Plastic Surgery, University Medical Centre Nijmegen, Nijmegen, The Netherlands. hartman@nvpc.nl
Summary
Microvascular osteocutaneous free flaps are vital for head and neck reconstruction. This review examines donor-site morbidity associated with common flaps, highlighting potential future advancements in reconstructive surgery.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Microvascular osteocutaneous free flaps are essential for reconstructing complex defects in head and neck surgery.
- Commonly used flaps include radial forearm, scapula, iliac crest, and fibula flaps, particularly for mandibular reconstruction.
Purpose of the Study:
- To review the literature on donor-site morbidity associated with various osteocutaneous free flaps used in head and neck reconstruction.
- To identify the types, incidence, and consequences of morbidity at flap donor sites.
Main Methods:
- Systematic literature review of studies reporting on microvascular osteocutaneous free flaps in head and neck reconstruction.
- Analysis of reported donor-site complications for radial forearm, scapula, iliac crest, and fibula flaps.
Main Results:
- Donor-site morbidity is an inevitable consequence of osteocutaneous flap harvest.
- The specific types and incidence of morbidity vary depending on the flap used.
- Reconstructive benefits of these flaps have historically overshadowed attention to donor-site complications.
Conclusions:
- Understanding and mitigating donor-site morbidity is crucial for optimizing patient outcomes in reconstructive surgery.
- Future research may focus on tissue-engineered prefabricated free flaps to potentially reduce donor-site morbidity.