Free Flap Reconstruction Following Ablative Tumor Surgery - Donor Site Morbidity And Life Quality

Objectives: The use of microvascular free flaps tailored specifically to the ablative surgical defects in the head and neck region has allowed precise anatomic reconstructions to be performed. The present prospective study investigated donor site morbidity and quality of life following cancer ablation and primary reconstruction.

Methods: Between 04/ 2005 and 04/ 2016 all patients undergoing microvascular reconstruction were recorded. Donor site morbidity was assesed for the patients undergoing flap harvest from the
shoulder and arm region using the DASH Score preoperatively as well as 1 and 3 months post operation. Quality of life was evaluated using the standardized QLQ-C30 and H&N35
questionaires developed by the European Organization for Research and Treatment of Cancer (EORTC).

Results: A total of 525 microvascular free flaps were transfered for head and neck reconstruction purpose. Among them were 231 scapula, 56 fibula, 180 radial forearm, 46 latissimus dorsi and 12 upper arm flaps. One month post operation the DASH score reached 52 % and decreased to 20 % until week 3 post operation.

Conclusion: The general quality of life (QLQ-C30) was negatively affected by age > 70 years(p = 0.05) and the head and neck specific quality of life (H&N35) was negatively affected by
radiation therapy, smoking habit and alcohol abuse.