Long-term results of blood flow and cutaneous sensibility of flaps used for the reconstruction of facial soft tissues.

PURPOSE

The aim of this study was to determine the blood flow and the cutaneous sensibility of flaps after the repair of tumor-related defects of the facial skin.

PATIENTS AND METHODS

Fifty restorations (27 local flaps, 6 island flaps, 7 free skin grafts, and 10 microvascular grafts) were examined using laser Doppler flowmetry, two-point discrimination, and a pain and thermal sensibility testing device. The average postoperative interval was 62 months. Measurements were performed on the flap surface, the donor site, and the contralateral areas corresponding to the donor site and the former defect. Paired t-tests were used to assess statistically significant differences between the sites of measurement.

RESULTS

Results showed a rate of both blood flow and two-point discrimination on the surface of local flaps and island flaps that was not statistically different from the corresponding area of the unoperated side. Free skin grafts exhibited incomplete restoration of thermal sensibility and increased blood flow rates compared with the donor site. Large microvascular flaps showed complete loss of cutaneous sensibility in six cases, whereas partial restitution without reproducible two-point discrimination was found in the remaining patients after an average interval of 39 months. Flowmetry rates of microvascular flaps corresponded to those of the donor site and were significantly lower than those of the recipient site in the head and neck area.