Management of the radial forearm free flap donor site with the Vacuum-Assisted Closure (VAC) system

Brian T. Andrews, Russell B. Smith, Kristi E. Chang, Joseph Scharpf, David P. Goldstein, Gerry F. Funk

Research output: Contribution to journalReview article

37 Scopus citations

Abstract

INTRODUCTION: The radial forearm free flap is a popular reconstructive flap in modern head and neck surgery. Poor wound healing at the forearm donor site is common and frequently results in tendon exposure. The Vacuum-Assisted Closure (VAC) system (Kinetic Concepts Inc., San Antonio, TX) is a topical negative pressure dressing that has been shown to improve skin graft viability when used as a bolster dressing. In this study, we investigated the use of the VAC system in the management of the radial forearm free flap donor site. METHODS: A retrospective chart review was performed on all subjects who underwent a radial forearm free flap reconstruction in which the VAC system was used as a bolster dressing at the donor site from January 1, 2003, through March 31, 2005. RESULTS: Thirty-four consecutive subjects were included in the study. Exposed tendon did not occur in 14 (0%) subjects in which the VAC bolster was used for a minimum of 6 days. Eleven of the 20 subjects (55%) who used the VAC bolster for 5 days demonstrated small amounts of tendon exposure (<2 cm) on follow-up clinic examination. The minimum follow up for all subjects was 4 months. CONCLUSION: This study demonstrates that the VAC system is a feasible alternative to conventional bolster dressing in the management of the radial forearm free flap skin-grafted donor site. Based on this study, when used for a minimum of 6 days, the VAC bolster dressing eliminated tendon exposure at the forearm donor site.

Original languageEnglish (US)
Pages (from-to)1918-1922
Number of pages5
JournalLaryngoscope
Volume116
Issue number10
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

Keywords

  • Bolster dressing
  • Radial forearm free flap donor site
  • Split-thickness skin graft
  • Topical negative pressure dressing
  • VAC
  • Vacuum-assisted closure

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Andrews, B. T., Smith, R. B., Chang, K. E., Scharpf, J., Goldstein, D. P., & Funk, G. F. (2006). Management of the radial forearm free flap donor site with the Vacuum-Assisted Closure (VAC) system. Laryngoscope, 116(10), 1918-1922. https://doi.org/10.1097/01.mlg.0000235935.07261.98