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Updated: Sep 26, 2025
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications
Abel P David1, Aaron L Zebolsky1,2, Andrea M Park1
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery University of California San Francisco California USA.
Background:
Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting.
Methods:
Prospective, single-blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1-3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection.
Results:
Twenty-nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1-3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits.
Conclusion:
MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation.Level of Evidence 2.
Insights
Microporous polysaccharide hemospheres (MPH) did not reduce postoperative fluid collection or complications at anterolateral thigh (ALT) flap donor sites. This study found no significant benefit of MPH in head and neck reconstruction patients.
Area of Science:
- Microsurgery
- Plastic Surgery
- Surgical Complications
Background:
- Postoperative seroma is a common complication after anterolateral thigh (ALT) free flap harvest.
- The efficacy of microporous polysaccharide hemospheres (MPH) as a hemostatic agent in this context is unknown.
Purpose of the Study:
- To evaluate the utility of topical MPH in reducing donor site complications following ALT free flap harvest for head and neck reconstruction.
Main Methods:
- A prospective, single-blind, randomized controlled trial was conducted.
- Patients received either topical MPH (3 g) or no treatment at the ALT donor site before closure.
- Outcomes measured included total drain output, drain output on postoperative days 1-3, drain duration, and incidence of hematoma, seroma, or infection.
Main Results:
- No significant differences were observed in total drain output, drain output on postoperative days 1-3, or drain duration between the MPH and control groups.
- The incidence of seroma, hematoma, and infection was not significantly different between the two groups.
- Factors such as gender, age, body weight, and smoking habits did not significantly influence drain output.
Conclusions:
- Topical MPH application to ALT free flap donor sites did not significantly improve drain output or reduce the formation of hematoma or seroma.
- The study provides Level 2 evidence regarding the limited utility of MPH in this surgical setting.
