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Open Access 01-07-2020 | Original Article

Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes

Authors: Stefan Hunger, Lukas Postl, Raphael Stehrer, Lukas Hingsammer, Stefan Krennmair, Wolfgang Feistl, Michael Malek, Gerald Krennmair

Published in: Clinical Oral Investigations | Issue 7/2020

Abstract

Objective

To evaluate the clinical, functional and aesthetic outcomes for radial forearm free flap (RFFF) donor sites covered with amniotic membrane (AM).

Material and methods

The healing process of patients with RFFF donor sites covered with AM was prospectively followed for 1 year. Additionally at the 12-month evaluation, objective scoring systems were used to assess the aesthetic (Vancouver scar scale, VSS: range 1–13) and functional outcome (skin sensibility, hand/wrist functionality [goniometer], grip strength [score 1 = excellent, 5 = poor]). By using a subjective rating system (score 1 = excellent, 5 = poor), the patient-reported aesthetic and functionality outcome was correlated with objective data analysis.

Results

Twenty-one out of 23 patients were followed for 12 months (dropout: 2 patients at 3 months). In 17/23 (73.9%) patients RFFF defect covered with AM showed an uneventful healing period (< 3 months). Prolonged healing periods (> 3 months < 6) for 6 patients (26.1%) were attributed to wound infections (4×), seroma (1×) and inflammation (1×). At the 1-year evaluation, there was a significant (p < 0.01) correlation between subjective (2.0 ± 0.71) and objective aesthetic scores (VVS 3.74 ± 2.18), and a successful grip strength (score 1.67 ± 0.86); however, thumb hyposensibility in 76.2% was seen. A high body mass index (BMI) was in conjunction with a negative (p = 0.012) and the use of antihypertensive medications provided positive effects (p = 0.041) on the aesthetic outcome.

Conclusion

RFFF donor site defects covered using AM show excellent clinical, aesthetic and functional outcome representing patient comorbidities (BMI, antihypertensive drugs) might affect the aesthetic outcome.

Clinical relevance

In relation to the excellent outcomes found, the use of AM offers an alternative treatment procedure for RFFF defect covering.

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Title: Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes
Authors: Stefan Hunger
Lukas Postl
Raphael Stehrer
Lukas Hingsammer
Stefan Krennmair
Wolfgang Feistl
Michael Malek
Gerald Krennmair
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 7/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-019-03104-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Use of amniotic membrane for radial forearm free flap donor site coverage: clinical, functional and cosmetic outcomes

Abstract

Objective

Material and methods

Results

Conclusion

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Material and methods

Results

Conclusion

Clinical relevance

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