Abstract：
The radial forearm free flap (RFFF) is commonly used in the reconstruction of oral cancer patients. Traditional RFFF (TRFFF) techniques, which often require a secondary donor site to repair the forearm defect, may result in a scar extending to the dorsal hand. This can lead to significant functional and aesthetic concerns in the forearm. We designed a modified RFFF (MRFFF) that incorporates a glasses-shaped flap and features deep venous drainage. To evaluate its effectiveness we conducted a retrospective chart review of 105 patients with oral squamous cell carcinoma who underwent reconstructive surgery between 2018 and 2022. These patients were treated either with a TRFFF (n = 60) or the newly developed MRFFF (n = 45). Our inclusion criteria, guided by preliminary surgical experience prior to initiating the study, stipulated that single oral defects should be no larger than 6 × 6 cm2, and adjacent double defects no larger than 3 × 6 cm2. Flap size, pedicle length, harvesting duration, and anastomosis during the surgical procedure were compared between the two techniques. Preoperative and postoperative oral function, recurrence, mortality, and dorsal scarring were recorded. One-week, one-month, and six-month postoperative subjective aesthetics assessments, and self-reported postoperative donor hand function, were measured using the Michigan hand questionnaire (MHQ). There were no significant differences between the groups in terms of flap size, pedicle length, harvesting time, anastomosis time, postoperative oral function, recurrence, and mortality. However, patients with a MRFFF did not require a second donor graft site and did not have scars extending to the dorsal forearm. They also had significantly improved postoperative aesthetic outcomes (1 week: 70.6%, 1 month: 62.2%) and donor hand function (1 week: 54.6%, 1 month: 40.4%) compared with the TRFFF group (p < 0.001). The MRFFF eliminates the need for secondary donor sites and improves primary donor site outcomes. It is versatile and can be employed for either single or composite oral defects. Through extensive case studies, we have defined its specific scope: it is suitable for single defects measuring no more than 6 × 6 cm2, or for composite defects no larger than 3 × 6 cm2. Furthermore, it does not compromise the functional recovery of the recipient site, and should be widely adopted for all qualifying patients.
摘要：
radial前臂游离皮瓣（RFFF）常用于口腔癌患者的重建。传统RFFF(TRFFF)技术,通常需要第二个供体部位来修复前臂缺损，可能会导致疤痕延伸到手背。这可能导致前臂中显著的功能和美学问题。我们设计了一种改良的RFFF（MRFFF），其中包含眼镜形皮瓣，并具有深静脉引流功能。为了评估其有效性，我们对2018年至2022年间接受重建手术的105例口腔鳞状细胞癌患者进行了回顾性图表回顾。这些患者使用TRFFF（n=60）或新开发的MRFFF（n=45）进行治疗。我们的纳入标准，在开始研究之前，以初步的手术经验为指导，规定单个口腔缺损不大于6×6cm2，相邻双缺损不大于3×6cm2。襟翼尺寸,椎弓根长度，收获持续时间，比较了两种技术在手术过程中的吻合情况。术前术后口腔功能,复发,死亡率,并记录背侧疤痕。一周,一个月,和术后六个月的主观美学评估，和自我报告的术后供体手功能，使用密歇根手问卷(MHQ)进行测量。两组间皮瓣大小无显著差异,椎弓根长度，收获时间,吻合时间,术后口腔功能,复发,和死亡率。然而,MRFFF患者不需要第二个供体移植部位,也没有延伸至前臂背侧的疤痕.他们也有显著改善术后美学结果（1周：70.6%，1个月：62.2％）和供体手功能（1周：54.6％，1个月：40.4％）与TRFFF组相比（p<0.001）。MRFFF消除了对次要供体部位的需要，并改善了主要供体部位的结果。它是通用的，可用于单一或复合口腔缺损。通过广泛的案例研究，我们已经定义了它的具体范围:它适用于不超过6×6cm2的单个缺陷，或不超过3×6cm2的复合缺陷。此外，它不会影响收件人站点的功能恢复，并应广泛适用于所有符合条件的患者。
