Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications
Abstract Background Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting. Me...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.770 |
| _version_ | 1818024904312750080 |
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| author | Abel P. David Aaron L. Zebolsky Andrea M. Park Chase M. Heaton P. Daniel Knott Rahul Seth |
| author_facet | Abel P. David Aaron L. Zebolsky Andrea M. Park Chase M. Heaton P. Daniel Knott Rahul Seth |
| author_sort | Abel P. David |
| collection | DOAJ |
| description | Abstract Background Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting. Methods Prospective, single‐blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1–3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection. Results Twenty‐nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1–3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation. Level of Evidence 2 |
| first_indexed | 2024-12-10T04:07:37Z |
| format | Article |
| id | doaj.art-3f6f1bd63bb64967b127a26dfb60f50b |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-10T04:07:37Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-3f6f1bd63bb64967b127a26dfb60f50b2022-12-22T02:02:48ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-04-017238038710.1002/lio2.770Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complicationsAbel P. David0Aaron L. Zebolsky1Andrea M. Park2Chase M. Heaton3P. Daniel Knott4Rahul Seth5Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USADivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USADivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USADivision of Head and Neck Oncologic Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USADivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USADivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology‐Head & Neck Surgery University of California San Francisco California USAAbstract Background Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting. Methods Prospective, single‐blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1–3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection. Results Twenty‐nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1–3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation. Level of Evidence 2https://doi.org/10.1002/lio2.770anterolateral thigh free flaphemostasismicroporous polysaccharide hemospheresmicrovascular reconstructionrandomized controlled trial |
| spellingShingle | Abel P. David Aaron L. Zebolsky Andrea M. Park Chase M. Heaton P. Daniel Knott Rahul Seth Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications Laryngoscope Investigative Otolaryngology anterolateral thigh free flap hemostasis microporous polysaccharide hemospheres microvascular reconstruction randomized controlled trial |
| title | Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| title_full | Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| title_fullStr | Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| title_full_unstemmed | Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| title_short | Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| title_sort | effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications |
| topic | anterolateral thigh free flap hemostasis microporous polysaccharide hemospheres microvascular reconstruction randomized controlled trial |
| url | https://doi.org/10.1002/lio2.770 |
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