Abstract：
Objective: To evaluate donor site morbidity of the serratus anterior free flap (SAFF) in head and neck reconstruction. Methods: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (0 no disability to 100 most severe disability) was applied to 20 patients (M: 16; F: 4) who underwent ablative surgery and reconstruction of the head and neck using a SAFF. Applications, as well as the donor site, recipient site and flap-related complications, were evaluated. Results: SAFF was mainly used for tongue (n = 11; 55.0%) and pharyngeal reconstruction after a laryngopharyngectomy (n = 4; 20.0%). The majority of patients presented with stage IV disease (n = 12; 60%) and had undergone previous radiotherapy (n = 14; 70%). Our free flap survival rate was 88.9% and the pectoralis major muscle flap (PMMF) was used in 5 patients as a salvage option to reconstruct pharyngeal defects. The mean/median DASH score was 21.6/19.9 (healthy norm 10.1), indicating only mild to moderate disability. However, free flap failure and the additional harvest of PMMF multiplies donor site morbidity since it was associated with a 3- and 2.6-times higher DASH score (46.0 vs. 15.5; p = 0.039 and 39.9 vs. 15.47; p = 0.081). Conclusions: The SAFF represents a versatile flap for head and neck reconstruction with low donor site morbidity.
摘要：
目的：评估前锯齿肌游离皮瓣（SAFF）在头颈部重建中的供体部位的发病率。方法：手臂的残疾，肩手（DASH）问卷（0无残疾至100最严重的残疾）应用于20例患者（M：16；F：4），这些患者使用SAFF进行了消融手术和头颈部重建。应用程序,以及捐赠现场，受体部位和皮瓣相关并发症，进行了评估。结果：SAFF主要用于喉咽切除术后的舌（n=11；55.0％）和咽部重建术（n=4；20.0％）。大多数患者患有IV期疾病（n=12；60％），并且先前接受过放射治疗（n=14；70％）。我们的游离皮瓣存活率为88.9％，5例患者使用胸大肌皮瓣（PMMF）作为重建咽部缺损的挽救选择。平均/中位数DASH评分为21.6/19.9（健康标准10.1），仅表示轻度至中度残疾。然而,游离皮瓣失败和额外收获PMMF会增加供体部位的发病率，因为它与DASH评分的3倍和2.6倍相关（46.0vs.15.5；p=0.039和39.9vs.15.47；p=0.081）。结论：SAFF代表了一种用于头颈部重建的多功能皮瓣，供体部位发病率低。
