Abstract：
OBJECTIVE: Radial Forearm Free flap (RFFF) is widely used in head and neck reconstruction, yet its donor site defect remains a significant drawback. The Medial Sural Artery Perforator Free Flap (MSAPFF) is considered an alternative flap to RFFF. This study aims to comprehensively analyze their characteristics, outcomes, and their impact on patient quality of life.
METHODS: All patients who underwent oral cavity reconstruction using RFFF and MSAPFF between February 2017 and April 2023 were included in this study. Flap characteristics, outcomes and post-operative complications were recorded and compared. Subjective donor site morbidity, aesthetic and functional results, and quality of life were also analyzed.
RESULTS: The study included 76 patients: 37 underwent reconstruction with RFFF, and 39 with MSAPFF. There was no significance difference between the RFFF and MSAPFF regarding the success rate (97.2% vs 97.4%), flap size (4.8 × 8.8 cm2 vs 5 × 9.8 cm2), hospital of stay (15.5 days vs 13.5 days) and recipient site complications (P > 0.05). However, MSAPFF showed larger flap thickness (P = 0.001), smaller arterial caliber (P = 0.008), shorter pedicle length (P = 0.001), and longer harvesting time (P < 0.001). No significant difference was observed between the pre-and postoperative ranges of wrist and ankle movements or in recipient site complications. MSAPFF showed a significant difference in donor site morbidity (P < 0.05).
CONCLUSIONS: The MSAPFF is an excellent alternative to the RFFF for repairing oral cavity defects, with additional advantage of a well-hidden scar on the posterior calf, a larger flap thickness, accepted pedicle length and arterial caliber. However, one should consider the harvesting time and surgical skills required in comparison to the RFFF.
CONCLUSIONS: The study highlights the importance of the MSAPFF as an alternative option for RFFF with less donor site morbidity and high success rate in oral cavity reconstruction and improved patient Quality of life after ablative surgery.
METHODS: All patients who underwent oral cavity reconstruction using RFFF and MSAPFF between February 2017 and April 2023 were included in this study. Flap characteristics, outcomes and post-operative complications were recorded and compared. Subjective donor site morbidity, aesthetic and functional results, and quality of life were also analyzed.
RESULTS: The study included 76 patients: 37 underwent reconstruction with RFFF, and 39 with MSAPFF. There was no significance difference between the RFFF and MSAPFF regarding the success rate (97.2% vs 97.4%), flap size (4.8 × 8.8 cm2 vs 5 × 9.8 cm2), hospital of stay (15.5 days vs 13.5 days) and recipient site complications (P > 0.05). However, MSAPFF showed larger flap thickness (P = 0.001), smaller arterial caliber (P = 0.008), shorter pedicle length (P = 0.001), and longer harvesting time (P < 0.001). No significant difference was observed between the pre-and postoperative ranges of wrist and ankle movements or in recipient site complications. MSAPFF showed a significant difference in donor site morbidity (P < 0.05).
CONCLUSIONS: The MSAPFF is an excellent alternative to the RFFF for repairing oral cavity defects, with additional advantage of a well-hidden scar on the posterior calf, a larger flap thickness, accepted pedicle length and arterial caliber. However, one should consider the harvesting time and surgical skills required in comparison to the RFFF.
CONCLUSIONS: The study highlights the importance of the MSAPFF as an alternative option for RFFF with less donor site morbidity and high success rate in oral cavity reconstruction and improved patient Quality of life after ablative surgery.
摘要：
目的：前臂游离皮瓣（RFFF）广泛应用于头颈部重建，然而，其供体部位缺陷仍然是一个显著的缺点。内侧腓肠动脉穿支自由襟翼（MSAPFF）被认为是RFFF的替代襟翼。本研究旨在全面分析其特点,结果，以及它们对患者生活质量的影响。
方法：本研究纳入了2017年2月至2023年4月期间使用RFFF和MSAPFF进行口腔重建的所有患者。襟翼特性,记录并比较结果和术后并发症。主观供体部位发病率，美学和功能结果，和生活质量也进行了分析。
结果：该研究包括76例患者：37例接受了RFFF重建，和39MSAPFF。RFFF和MSAPFF之间的成功率没有显着差异（97.2％vs97.4％），皮瓣尺寸（4.8×8.8cm2对5×9.8cm2），住院时间（15.5天比13.5天）和受体部位并发症（P>0.05）。然而,MSAPFF显示皮瓣厚度较大（P=0.001），较小的动脉口径（P=0.008），椎弓根长度较短（P=0.001），和更长的收获时间（P<0.001）。腕关节和踝关节运动的前后范围或受体部位并发症之间没有显着差异。MSAPFF显示供体部位发病率差异显著(P<0.05)。
结论：MSAPFF是修复口腔缺陷的RFFF的绝佳替代品，除了小腿后部隐藏的疤痕之外，较大的皮瓣厚度，接受椎弓根长度和动脉口径。然而,与RFFF相比，应考虑收获时间和手术技能。
结论：该研究强调了MSAPFF作为RFFF的替代选择的重要性，具有较低的供体部位发病率和较高的口腔重建成功率，并改善了患者消融手术后的生活质量。
方法：本研究纳入了2017年2月至2023年4月期间使用RFFF和MSAPFF进行口腔重建的所有患者。襟翼特性,记录并比较结果和术后并发症。主观供体部位发病率，美学和功能结果，和生活质量也进行了分析。
结果：该研究包括76例患者：37例接受了RFFF重建，和39MSAPFF。RFFF和MSAPFF之间的成功率没有显着差异（97.2％vs97.4％），皮瓣尺寸（4.8×8.8cm2对5×9.8cm2），住院时间（15.5天比13.5天）和受体部位并发症（P>0.05）。然而,MSAPFF显示皮瓣厚度较大（P=0.001），较小的动脉口径（P=0.008），椎弓根长度较短（P=0.001），和更长的收获时间（P<0.001）。腕关节和踝关节运动的前后范围或受体部位并发症之间没有显着差异。MSAPFF显示供体部位发病率差异显著(P<0.05)。
结论：MSAPFF是修复口腔缺陷的RFFF的绝佳替代品，除了小腿后部隐藏的疤痕之外，较大的皮瓣厚度，接受椎弓根长度和动脉口径。然而,与RFFF相比，应考虑收获时间和手术技能。
结论：该研究强调了MSAPFF作为RFFF的替代选择的重要性，具有较低的供体部位发病率和较高的口腔重建成功率，并改善了患者消融手术后的生活质量。
