Management of the radial forearm free flap donor site with the vacuum-assisted closure (VAC) system

Brian T Andrews; Russell B Smith; Kristi E Chang; Joseph Scharpf; David P Goldstein; Gerry F Funk

doi:10.1097/01.mlg.0000235935.07261.98

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Management of the radial forearm free flap donor site with the vacuum-assisted closure (VAC) system

Journal article

Peer reviewed

Management of the radial forearm free flap donor site with the vacuum-assisted closure (VAC) system

Brian T Andrews, Russell B Smith, Kristi E Chang, Joseph Scharpf, David P Goldstein and Gerry F Funk

The Laryngoscope, Vol.116(10), pp.1918-1922

10/2006

DOI: 10.1097/01.mlg.0000235935.07261.98

PMID: 17003705

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Abstract

The radial forearm free flap is a popular reconstructive flap in modern head and neck surgery. Poor wound healing at the forearm donor site is common and frequently results in tendon exposure. The Vacuum-Assisted Closure (VAC) system (Kinetic Concepts Inc., San Antonio, TX) is a topical negative pressure dressing that has been shown to improve skin graft viability when used as a bolster dressing. In this study, we investigated the use of the VAC system in the management of the radial forearm free flap donor site. A retrospective chart review was performed on all subjects who underwent a radial forearm free flap reconstruction in which the VAC system was used as a bolster dressing at the donor site from January 1, 2003, through March 31, 2005. Thirty-four consecutive subjects were included in the study. Exposed tendon did not occur in 14 (0%) subjects in which the VAC bolster was used for a minimum of 6 days. Eleven of the 20 subjects (55%) who used the VAC bolster for 5 days demonstrated small amounts of tendon exposure (<2 cm) on follow-up clinic examination. The minimum follow up for all subjects was 4 months. This study demonstrates that the VAC system is a feasible alternative to conventional bolster dressing in the management of the radial forearm free flap skin-grafted donor site. Based on this study, when used for a minimum of 6 days, the VAC bolster dressing eliminated tendon exposure at the forearm donor site.

Surgical Flaps

Granulation Tissue - pathology

Follow-Up Studies

Granulation Tissue - physiopathology

Humans

Middle Aged

Postoperative Complications - prevention & control

Male

Forearm - surgery

Feasibility Studies

Occlusive Dressings - classification

Vacuum

Time Factors

Aged, 80 and over

Adult

Female

Retrospective Studies

Radius - surgery

Tissue and Organ Harvesting - methods

Skin Transplantation - methods

Pressure

Tendons - physiopathology

Tendons - pathology

Aged

Wound Healing - physiology

Bone Transplantation - methods

Details

Title: Subtitle: Management of the radial forearm free flap donor site with the vacuum-assisted closure (VAC) system
Creators: Brian T Andrews - University of Iowa College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Iowa City, Iowa, USA. gerry-funk@uiowa.edu
Russell B Smith
Kristi E Chang
Joseph Scharpf
David P Goldstein
Gerry F Funk
Resource Type: Journal article
Publication Details: The Laryngoscope, Vol.116(10), pp.1918-1922
DOI: 10.1097/01.mlg.0000235935.07261.98
PMID: 17003705
NLM abbreviation: Laryngoscope
ISSN: 0023-852X
eISSN: 1531-4995
Publisher: United States
Language: English
Date published: 10/2006
Academic Unit: Radiation Oncology; Craniofacial Anomalies Research Center; Neurosurgery; Otolaryngology
Record Identifier: 9984006408602771

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