Outcomes for 160 Consecutive Lateral Arm Free Flaps for Head and Neck Reconstruction

Contrera, Kevin J.; Hassan, Abbas M.; Shuck, John W.; Bobian, Michael; Ha, Austin Y.; Chang, Edward I.; Garvey, Patrick B.; Roubaud, Margaret S.; Lee, Z‐Hye; Hanasono, Mathew M.; Gross, Neil D.; Myers, Jeffrey N.; Yu, Peirong; Largo, Rene D.

doi:10.1002/ohn.596

Cited by 2 publications

(1 citation statement)

References 43 publications

(86 reference statements)

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“…The closure of the donor site for the lateral arm flaps should be carried out without tension and without re-approximation of the muscle or closure of the deep layers. A tight closure can result in radial nerve palsy with post-operative swelling that has catastrophic consequences if the radial nerve deficits do not resolve [ 20 ]. Thus, even if the flap harvest is performed using a no-touch technique, paying careful attention to protect the nerve, a tight closure can still result in neurologic deficits.…”

Section: Lateral Arm and Lateral Forearm Flapmentioning

confidence: 99%

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Lee,

Canzi,

et al. 2024

JCM

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The field of microsurgical head and neck reconstruction has witnessed tremendous advancements in recent years. While the historic goals of reconstruction were simply to maximize flap survival, optimizing both aesthetic and functional outcomes has now become the priority. With an increased understanding of perforator anatomy, improved technology in instruments and microscopes, and high flap success rates, the reconstructive microsurgeon can push the envelope in harvesting and designing the ideal flap to aid patients following tumor extirpation. Furthermore, with improvements in cancer treatment leading to improved patient survival and prognosis, it becomes increasingly important to have a broader repertoire of donor sites. The present review aims to provide a review of newly emerging soft tissue flap options in head and neck reconstruction. While certainly a number of bony flap options also exist, the present review will focus on soft tissue flaps that can be harvested reliably from a variety of alternate donor sites. From the upper extremity, the ulnar forearm as well as the lateral arm, and from the lower extremity, the profunda artery perforator, medial sural artery perforator, and superficial circumflex iliac perforator flaps will be discussed, and we will provide details to aid reconstructive microsurgeons in incorporating these alternative flaps into their armamentarium.

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Section: Lateral Arm and Lateral Forearm Flapmentioning

confidence: 99%

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Lee,

Canzi,

et al. 2024

JCM

Self Cite

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Indications, Postoperative Outcomes, and Complications of the Lateral Arm Free Flap: A Systematic Review and Meta-analysis

Dong,

Martineau,

Kalbermatten

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: The lateral arm free flap (LA-FF) has become an increasingly popular choice in the reconstruction of soft tissue defect in many anatomical regions. However, there is a paucity of literature regarding its safety and efficacy. The aim of this study is to analyze its different applications along with their surgical outcomes. Methods: A systematic review including all studies assessing the surgical outcomes of the LA-FF and proportional meta-analysis using a random-effect DerSimonian–Laird model was performed to assess the postsurgical complications and flap failures. Results: Twenty-five articles were included in the final analysis, representing a total of 1272 flaps in 1256 patients. Indications were mainly defects following tumoral resection and trauma. Across the different studies, the reported flap size range varied from 2 × 4 cm to 12 × 16 cm. The overall pooled flap failure rate across all indications was 3% [95% confidence interval (CI), 0.01–0.04], with a pooled failure rate of 2% (95% CI, 0.01–0.04) in the head and neck region, 3% (95% CI, 0.01–0.06) in the upper limb region, and 3% (95% CI, 0.01–0.06) in studies evaluating its use in different anatomical locations. The overall donor site complication rate was 11% (95% CI, 0.03–0.21), with no major complications described. Conclusions: This meta-analysis demonstrates safety and efficacy of the LA-FF in reconstructing moderate to large soft tissue defects. It is mainly used for head and neck posttumoral resection and upper and lower limb posttraumatic reconstruction.

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Outcomes for 160 Consecutive Lateral Arm Free Flaps for Head and Neck Reconstruction

Cited by 2 publications

References 43 publications

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Expanding the Armamentarium of Donor Sites in Microvascular Head and Neck Reconstruction

Indications, Postoperative Outcomes, and Complications of the Lateral Arm Free Flap: A Systematic Review and Meta-analysis

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