<< Back to the abstract archive
Radial Forearm Flap Donor Site Morbidity: A Systematic Review and Meta-Analysis
Rotatori RM, Ovalle F, Elhadi-Babiker H, Gobble R
University of Cincinnati
2017-02-15
Presenter: Max Rotatori
Affidavit:
This student was responsible for a significant portion of the conception, design, data collection, analysis of data, and abstract drafting for this project. This study has not been previously presented.
Director Name: David A Billmire
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Background
The common reconstructive workhorse radial forearm flap has a notoriously known but not well-quantified donor site morbidity rate. This systematic review and meta-analysis explores the incidence of radial forearm flap donor site morbidity.
Methods
A systematic review was performed of PubMed, Scopus, Embase, and Cinahl databases utilizing the terms "radial forearm flap" and "donor site." Only English language, prospective studies from 1981 to present were included. Measures of flap characteristics, donor site treatment and morbidity were pooled and analyzed.
Results
Search identified 778 unique studies, 24 of which were qualifying prospective studies – 8 randomized controlled trials and 16 cohort studies. A total of 1156 patients with 1157 flaps were analyzed. 521 (45%) were subfascial, 275 (28%) suprafascial, 43 (4%) composite, and 275 (23%) unspecified. A mean donor defect size of 49cm2 was either closed primarily (5%), with split-thickness skin grafting (39%), full-thickness skin grafting (51%), or a biologic matrix (6%). Average follow-up was 11 months. The most common early (<30 days) donor site morbidities were partial graft loss (7%); tendon exposure (4%), and complete graft loss (1%). Late (>30 days) donor site morbidities included dysesthesia (24%), decreased range of motion (10%), undesirable scarring (4%), and decreased strength (2%).
Conclusions
Overall donor site morbidity of the radial forearm flap is low, yet rates of mild impairments in range of motion and sensation are not negligible. Understanding the incidence of these impairments enables surgeons to counsel patients about realistic postoperative donor site expectations.
