Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Rieder, M.
Donor Site Morbidity and Quality of Life After Microvascular Head and Neck Reconstruction with a Chimeric, Thoracodorsal, Perforator-Scapular Flap Based on the Angular Artery (TDAP-Scap-aa flap)
Humanmedizin; [ Diplomarbeit ] Medizinische Universitaet Graz; 2022. pp. 68
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Wallner Jürgen
- Zemann Wolfgang
- Altmetrics:
- Abstract:
- Background: Extensive defects in the head and neck area often require the use of advanced free flap reconstruction techniques. In such cases, where both soft and hard tissues are part of the defect, the thoracodorsal perforator-scapular free flap based on the angular artery (TDAP-Scap-aa flap) has recently been described as a novel microvascular treatment option in the head and neck reconstruction. However, postoperative donor site morbidity and/or quality of life assessments associated with this novel reconstruction technique have not been investigated yet. Materials and Methods: In this retrospective study, the quality of life and donor site morbidity were postoperatively evaluated over a five-year period (2016–2020) using the standardized SF-36 and the DASH questionnaires in 20 selected cases (n = 20). The postoperative quality of life and donor site morbidity were assessed approximately one year (10–14 months) after extensive head and neck defect reconstruction with the TDAP-Scap-aa flap. The acquired results were compared with the already established data of the healthy German and U.S. norm population (healthy control group). Furthermore, an electronic clinical chart review of the included patients was conducted to collect the demographic data and the harvesting details of the surgery. Results: On average, the harvested microvascular free flaps consisted of 7,8 ± 2,1 cm bone and 86 ± 49,8 cm2 soft tissue components. At the donor site (subscapular region) only mild morbidity was observed postoperatively with a mean DASH score of 21,74 ± 7,3 points. This result can be assigned to the second lowest tier in the five-tier category rating of donor site morbidity (very mild to very severe). When comparing the patients’ postoperative quality of life to the healthy German norm population, the observed SF-36 values were within the upper third (> 66 %) of the established norm values in almost all quality of life subcategories. Conclusions: The actual impact of microvascular flap harvest on the patients’ quality of life is hardly assessable due to various confounders that occur or may occur within the clinical routine or the preoperative environment. However, the mild donor site morbidity and the observed quality of life located in the upper third of the healthy norm population indicates only minor postoperative impairment when using the novel TDAP-Scap-aa free flap. This flap is therefore suitable for the treatment of advanced combined soft and hard tissue head and neck defects.