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The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site

INTRODUCTION: Sensory disturbance due to injury of the superficial branch of the radial nerve (SBRN) is a donor-site morbidity of the radial forearm (RF) flap. The relationship between the SBRN preservation method and the post-operative sensation at the flap donor-site was retrospectively investigat...

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Autores principales: Kitano, Daiki, Morimatsu, Yasuyuki, Murai, Nobuyuki, Osaki, Takeo, Sakakibara, Shunsuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese Society for Regenerative Medicine 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338196/
https://www.ncbi.nlm.nih.gov/pubmed/37448851
http://dx.doi.org/10.1016/j.reth.2023.06.013
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author Kitano, Daiki
Morimatsu, Yasuyuki
Murai, Nobuyuki
Osaki, Takeo
Sakakibara, Shunsuke
author_facet Kitano, Daiki
Morimatsu, Yasuyuki
Murai, Nobuyuki
Osaki, Takeo
Sakakibara, Shunsuke
author_sort Kitano, Daiki
collection PubMed
description INTRODUCTION: Sensory disturbance due to injury of the superficial branch of the radial nerve (SBRN) is a donor-site morbidity of the radial forearm (RF) flap. The relationship between the SBRN preservation method and the post-operative sensation at the flap donor-site was retrospectively investigated. METHODS: We included 39 patients who underwent head and neck reconstruction with a free RF flap at Hyogo Cancer Center between April 2014 and March 2018. The patients were classified into the following three groups according to the SBRN preservation method: group 1, zero preservation, excision of the entire SBRN; group 2, main trunk preservation, excision of all branches except the main trunk of the SBRN; and group 3, complete preservation, preservation of the entire SBRN. Objective sensations and subjective symptoms at the flap donor-site were analyzed. RESULTS: The mean objective sensory scores were 3.18, 2.97, and 1.78 in groups 1, 2, and 3, respectively. Differences between groups 1 and 3 and between groups 2 and 3 were significant (p = 0.0035 and p = 0.037, respectively). The mean subjective symptom scores were 2.40, 1.33, and 1.40 in groups 1, 2, and 3, respectively. Differences between groups 1 and 2, and between groups 1 and 3 were significant (p = 0.032 and p = 0.019, respectively). CONCLUSIONS: Zero preservation method had a higher risk of subjective symptoms and objective hypoesthesia development at the flap donor-site than the complete preservation method. Despite inevitable objective hypoesthesia, the main trunk preservation prevented the development of subjective symptoms. Complete preservation is optimal for RF flap harvest; however, in case of perforator crossing, main trunk preservation is another option.
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spelling pubmed-103381962023-07-13 The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site Kitano, Daiki Morimatsu, Yasuyuki Murai, Nobuyuki Osaki, Takeo Sakakibara, Shunsuke Regen Ther Original Article INTRODUCTION: Sensory disturbance due to injury of the superficial branch of the radial nerve (SBRN) is a donor-site morbidity of the radial forearm (RF) flap. The relationship between the SBRN preservation method and the post-operative sensation at the flap donor-site was retrospectively investigated. METHODS: We included 39 patients who underwent head and neck reconstruction with a free RF flap at Hyogo Cancer Center between April 2014 and March 2018. The patients were classified into the following three groups according to the SBRN preservation method: group 1, zero preservation, excision of the entire SBRN; group 2, main trunk preservation, excision of all branches except the main trunk of the SBRN; and group 3, complete preservation, preservation of the entire SBRN. Objective sensations and subjective symptoms at the flap donor-site were analyzed. RESULTS: The mean objective sensory scores were 3.18, 2.97, and 1.78 in groups 1, 2, and 3, respectively. Differences between groups 1 and 3 and between groups 2 and 3 were significant (p = 0.0035 and p = 0.037, respectively). The mean subjective symptom scores were 2.40, 1.33, and 1.40 in groups 1, 2, and 3, respectively. Differences between groups 1 and 2, and between groups 1 and 3 were significant (p = 0.032 and p = 0.019, respectively). CONCLUSIONS: Zero preservation method had a higher risk of subjective symptoms and objective hypoesthesia development at the flap donor-site than the complete preservation method. Despite inevitable objective hypoesthesia, the main trunk preservation prevented the development of subjective symptoms. Complete preservation is optimal for RF flap harvest; however, in case of perforator crossing, main trunk preservation is another option. Japanese Society for Regenerative Medicine 2023-06-30 /pmc/articles/PMC10338196/ /pubmed/37448851 http://dx.doi.org/10.1016/j.reth.2023.06.013 Text en © 2023 The Japanese Society for Regenerative Medicine. Production and hosting by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Kitano, Daiki
Morimatsu, Yasuyuki
Murai, Nobuyuki
Osaki, Takeo
Sakakibara, Shunsuke
The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title_full The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title_fullStr The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title_full_unstemmed The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title_short The superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
title_sort superficial branch of the radial nerve and sensory disturbance in the radial forearm flap donor-site
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10338196/
https://www.ncbi.nlm.nih.gov/pubmed/37448851
http://dx.doi.org/10.1016/j.reth.2023.06.013
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