腓骨(FFF)和肩胛骨游离皮瓣(SFF)是用于头颈部重建的多功能组织转移。然而,对它们的相对发病率进行了稀疏研究。这项研究的主要目标是评估这两种重建方案的发病率和患者报告的结局指标。
2017年至2020年接受FFF或SFF头颈部消融的病例系列。人口统计和手术结果测量,如Charlson合并症指数(CCI),麻醉时间,供体部位发病率,提取围手术期发病率评分(POMs)。联系患者以完成决策后悔量表(DRS),华盛顿大学生活质量(UW-QoL)口腔健康影响-14和肢体特定功能结果测量。统计分析包括线性回归。
总共,包括97FFF(平均年龄58.5,男性62.9%)和55SFF(平均年龄64.8,男性63.6%)。SFF组总手术时间较高(p<0.05),合并症较多(p<0.01)。SFF患者在术后第3天POM得分较低(p<0.05),而FFF患者在UW-QoL物理领域得分较高(p<0.01)。两组的DRS(FFF平均DRS22.7,SFF平均DRS19.2)相似。当根据患者发病率进行调整时,然而,SFF组的决策遗憾较少(p<0.05)。
这是对FFF和SFF患者报告结果指标的最大综合评估。SFF需要更长的手术时间,但早期发病率低于FFF。接受两种重建的患者都报告了轻度的决策遗憾,证明这些通常是耐受性良好的程序。
Fibular (FFF) and scapular free flaps (SFF) are versatile tissue transfers for head and neck reconstruction. However, their relative morbidity has been sparsely studied. The primary goal of this study was to evaluate the morbidity and patient-reported outcome measures of these two reconstructive options.
Case series of patients from 2017 to 2020 who underwent a FFF or SFF for head and neck ablation. Demographic and surgical outcome measures, such as Charlson Comorbidity Index (CCI), anesthetic time, donor site morbidity, and perioperative morbidity score (POMs) were extracted. Patients were contacted to complete the Decision Regret Scale (DRS), University of Washington Quality of Life (UW-QoL), Oral Health Impact-14, and limb specific functional outcome measures. Statistical analyses included a linear regression.
In total, 97 FFF (mean age 58.5, 62.9% male) and 55 SFF (mean age 64.8, 63.6% male) were included. Total surgical time was higher in the SFF group (p < 0.05) and they had more comorbidities (p < 0.01). SFF patients had lower POM scores on post-operative day three (p < 0.05) while FFF patients scored better on the UW-QoL Physical Domain (p < 0.01). The DRS for both groups (FFF mean DRS 22.7, SFF mean DRS 19.2) was similar. When adjusted for patient morbidity, however, the SFF group had less decisional regret (p < 0.05).
This is the largest comprehensive evaluation of patient-reported outcome measures for FFF and SFFs. SFFs required longer surgical times but had less early morbidity than FFFs. Patients who underwent either reconstructions reported mild decisional regret, proving these are generally well tolerated procedures.