Hand: Microsurgery and Flaps

A Prospective Cohort Study of Fibula Free Flap Donor-Site Morbidity in 157 Consecutive Patients

Momoh AO, Yu P, Skoracki RJ, et al (Univ of Texas M. D. Anderson Cancer Ctr, Houston) Plast Reconstr Surg 128:714-720, 2011^§

Abstract

Background

Although the fibula free flap is preferred for bony head and neck reconstruction, donor-site morbidity remains a concern. The authors goal was to evaluate potential risk factors for complications and whether the type of wound closure and timing of postoperative ambulation had an effect on the development of short- and long-term morbidities.

Methods

A prospective cohort study of donor-site morbidity was performed in 157 consecutive patients who underwent fibula free flap reconstruction for head and neck defects.

Results

Perioperative donor-site complications occurred in 31.2 percent of patients, including skin graft loss (15 percent), cellulitis (10 percent), wound dehiscence (8 percent), and abscess (1 percent). Preoperative chemotherapy (p = 0.02) was associated with increased complications. No significant difference in complication rates was observed between primary and skin graft wound closure (p

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