Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study
Abstract Background Computer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery. Met...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01899-z |
| _version_ | 1797952720107208704 |
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| author | Leonard Simon Brandenburg Pit Jacob Voss Thomas Mischkowsky Jan Kühle Michael Andreas Ermer Julia Vera Weingart René Marcel Rothweiler Marc Christian Metzger Rainer Schmelzeisen Philipp Poxleitner |
| author_facet | Leonard Simon Brandenburg Pit Jacob Voss Thomas Mischkowsky Jan Kühle Michael Andreas Ermer Julia Vera Weingart René Marcel Rothweiler Marc Christian Metzger Rainer Schmelzeisen Philipp Poxleitner |
| author_sort | Leonard Simon Brandenburg |
| collection | DOAJ |
| description | Abstract Background Computer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery. Methods This study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques. A cross-sectional examination was performed to determine range of motion, muscle strength and nerve disturbances. Furthermore, correlations between graft volume and skin incision length with postoperative donor site morbidity were assessed using Spearman's rank correlation, linear regression and analysis of variance (ANOVA). Results Fifteen patients with a mean graft volume of 21.2 ± 5.7 cm3 and a mean incision length of 228.0 ± 30.0 mm were included. Patients reported of noticeable physical limitations in daily life activities (12.3 ± 11.9 weeks) and athletic activities (38.4 ± 40.0 weeks in mean) following surgery. Graft volume significantly correlated with the duration of the use of walking aids (R = 0.57; p = 0.033) and impairment in daily life activities (R = 0.65; p = 0.012). The length of the scar of the donor-site showed a statistically significant association with postoperative iliohypogastric nerve deficits (F = 4.4, p = 0.037). Patients with anaesthaesia of a peripheral cutaneous nerve had a larger mean scar length (280 ± 30.0 mm) than subjects with hypaesthesia (245 ± 10.1 mm) or no complaints (216 ± 27.7 mm). Conclusions Despite sophisticated planning options in modern CAD/CAM surgery, comorbidity of the donor site following iliac graft harvesting is still a problem. This study is the first to investigate comorbidity after DCIA graft raising in a patient group treated exclusively with CAD/CAM techniques. The results indicate that a minimal invasive approach in terms of small graft volumes and small skin incisions could help to reduce postoperative symptomatology. Trial registration Retrospectively registered at the German Clinical Trials Register (DRKS-ID: DRKS00029066); registration date: 23/05/2022 |
| first_indexed | 2024-04-10T22:50:42Z |
| format | Article |
| id | doaj.art-a8201df4066c4b1e912f836ce336187a |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-10T22:50:42Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-a8201df4066c4b1e912f836ce336187a2023-01-15T12:03:23ZengBMCBMC Surgery1471-24822023-01-0123111210.1186/s12893-022-01899-zDonor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional studyLeonard Simon Brandenburg0Pit Jacob Voss1Thomas Mischkowsky2Jan Kühle3Michael Andreas Ermer4Julia Vera Weingart5René Marcel Rothweiler6Marc Christian Metzger7Rainer Schmelzeisen8Philipp Poxleitner9Department of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Orthopedics and Trauma Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of FreiburgAbstract Background Computer Assisted Design and Computer Assisted Manufacturing (CAD/CAM) have revolutionized oncologic surgery of the head and neck. A multitude of benefits of this technique has been described, but there are only few reports of donor site comorbidity following CAD/CAM surgery. Methods This study investigated comorbidity of the hip following deep circumflex iliac artery (DCIA) graft raising using CAD/CAM techniques. A cross-sectional examination was performed to determine range of motion, muscle strength and nerve disturbances. Furthermore, correlations between graft volume and skin incision length with postoperative donor site morbidity were assessed using Spearman's rank correlation, linear regression and analysis of variance (ANOVA). Results Fifteen patients with a mean graft volume of 21.2 ± 5.7 cm3 and a mean incision length of 228.0 ± 30.0 mm were included. Patients reported of noticeable physical limitations in daily life activities (12.3 ± 11.9 weeks) and athletic activities (38.4 ± 40.0 weeks in mean) following surgery. Graft volume significantly correlated with the duration of the use of walking aids (R = 0.57; p = 0.033) and impairment in daily life activities (R = 0.65; p = 0.012). The length of the scar of the donor-site showed a statistically significant association with postoperative iliohypogastric nerve deficits (F = 4.4, p = 0.037). Patients with anaesthaesia of a peripheral cutaneous nerve had a larger mean scar length (280 ± 30.0 mm) than subjects with hypaesthesia (245 ± 10.1 mm) or no complaints (216 ± 27.7 mm). Conclusions Despite sophisticated planning options in modern CAD/CAM surgery, comorbidity of the donor site following iliac graft harvesting is still a problem. This study is the first to investigate comorbidity after DCIA graft raising in a patient group treated exclusively with CAD/CAM techniques. The results indicate that a minimal invasive approach in terms of small graft volumes and small skin incisions could help to reduce postoperative symptomatology. Trial registration Retrospectively registered at the German Clinical Trials Register (DRKS-ID: DRKS00029066); registration date: 23/05/2022https://doi.org/10.1186/s12893-022-01899-zMandible reconstructionDeep circumflex iliac arteryComorbidity |
| spellingShingle | Leonard Simon Brandenburg Pit Jacob Voss Thomas Mischkowsky Jan Kühle Michael Andreas Ermer Julia Vera Weingart René Marcel Rothweiler Marc Christian Metzger Rainer Schmelzeisen Philipp Poxleitner Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study BMC Surgery Mandible reconstruction Deep circumflex iliac artery Comorbidity |
| title | Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study |
| title_full | Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study |
| title_fullStr | Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study |
| title_full_unstemmed | Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study |
| title_short | Donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts: a cross sectional study |
| title_sort | donor site morbidity after computer assisted surgical reconstruction of the mandible using deep circumflex iliac artery grafts a cross sectional study |
| topic | Mandible reconstruction Deep circumflex iliac artery Comorbidity |
| url | https://doi.org/10.1186/s12893-022-01899-z |
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