Thiem Daniel G E, Siegberg Fabia, Römer Paul, Blatt Sebastian, Pabst Andreas, Heimes Diana, Al-Nawas Bilal, Kämmerer Peer W
Department of Oral and Maxillofacial Surgery, University Medical Centre Mainz, 55131 Mainz, Germany.
Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany.
J Clin Med. 2022 Jun 22;11(13):3601. doi: 10.3390/jcm11133601.
This clinical prospective randomized controlled study aimed to investigate the differences between Radial (RFFF) and Ulnar (UFFF) Forearm Free Flap in terms of success, performance, and donor site morbidity. Thirty patients with reconstruction of the head and neck region were included. For the first time, this study assessed flap-perfusion characteristics, donor-site-wound-healing dynamics and hand perfusion using hyperspectral imaging. Further, subjective (Likert-scale, DASH-score) and objective (grip/pinch-strength) parameters of donor site morbidity were analysed. Postoperative follow-up was performed until 6 months after index surgery. With 100% of patients, RFFF and UFFF were equally successful. Compared to surrounding reference, UFFF revealed significant lower tissue oxygenation saturation (StO) than RFFF. Compared with UFFF, blood flow in both the thenar and hypothenar region were significantly reduced 6 months following RFFF transfer. After four weeks, 27% more patients demonstrated impaired wound healing following RFFF transfer. After 6 months, epithelial-surface continuity was restored in all patients of both groups. After 6 months, overall rates of both subjective and objective donor site morbidity were comparable between RFFF and UFFF. RFFF and UFFF both demonstrate similar success rates and HSI-perfusion dynamics following transfer. After 4 weeks, wound-healing disorder appeared significantly more often in RFFF than in UFFF; however, they became equal after 6 months. RFFF and UFFF can be considered as mutual alternatives.
这项临床前瞻性随机对照研究旨在探讨桡侧游离前臂皮瓣（RFFF）和尺侧游离前臂皮瓣（UFFF）在成功率、性能和供区并发症方面的差异。纳入了30例头颈部重建患者。本研究首次使用高光谱成像评估皮瓣灌注特征、供区伤口愈合动态和手部灌注情况。此外，还分析了供区并发症的主观参数（李克特量表、DASH评分）和客观参数（握力/捏力）。术后随访至首次手术后6个月。100%的患者中，RFFF和UFFF的成功率相同。与周围对照相比，UFFF的组织氧合饱和度（StO）显著低于RFFF。与UFFF相比，RFFF转移后6个月，大鱼际和小鱼际区域的血流均显著减少。四周后，RFFF转移后伤口愈合受损的患者多27%。6个月后，两组所有患者的上皮表面连续性均得以恢复。6个月后，RFFF和UFFF供区并发症的总体主观和客观发生率相当。RFFF和UFFF转移后的成功率和高光谱成像灌注动态相似。四周后，RFFF伤口愈合障碍的发生率明显高于UFFF；然而，6个月后二者相当。RFFF和UFFF可被视为相互替代方案。
