Vol.:(0123456789) 1 3 Oral Cancer (2018) 2:27–35 https://doi.org/10.1007/s41548-018-0006-z ORIGINAL ARTICLE Comparison of the outcome of suprafacial and subfacial dissection of radial forearm in head and neck reconstruction Anil Kumar Desai 1 · Niranjan Kumar 1 · Vividha Singhania 1 · K. B. Srikanth 1 · Avinash Prabhu 1 Received: 29 September 2017 / Accepted: 21 February 2018 / Published online: 12 March 2018 © Springer International Publishing AG, part of Springer Nature 2018 Abstract Purpose Radial forearm fap is a versatile and reliable tool in oral cancer reconstruction. However, a spectrum of donor-site defcits following harvest of this fap has been reported. Several surgical technique has been proposed to improve skin graft take and tendon exposure and subsequent undesirable results at donor site. Objective The study was conducted to compare the donor-site morbidity associated with suprafacial radial forearm fap to that with subfacial donor site in oral cancer reconstructive surgery at our unit. Methodology A total of 20 patients were included in the study and were categorized into suprafacial group and subfacial group. The donor-site morbidity was assessed both objectively and subjectively at 15 days, 1 month and 4 months postop- eratively. The subjective evaluation was done using patient-related wrist elevation and patient and observer scar assessment. Results The suprafacial showed 80% of patients with complete graft uptake when compared to 50% in subfacial group and 20% showed delayed healing in subfacial group. Range of motion and grip strength was found higher in suprafacial group. Subjective evaluation revealed a better aesthetic out come in suprafacial group. The subjective evaluation for pain and func- tion did not reveal a statistically signifcant diference between two groups. Conclusion The study of donor-site morbidity clearly demonstrates the superiority of suprafacial technique over subfacial technique. Keywords Radial forearm · Flap · Suprafascial · Subfascial · Goniometer · Dynamometer Introduction Radial forearm fap was frst described in 1981 by Yang et al. [1]. It is considered as the new workhorse in micro- vascular reconstruction of various head and neck surgical defects [2]. It is a versatile and reliable tool in oral cancer reconstruction. Much like its reliable and unquestionably useful pedicled predecessors (that is pectoralis major myocutaneous fap), the radial forearm has several distinct advantages. However, in common with all forms of local and distant fap reconstructions, these advantages have to be balanced against potential complications at the donor site. A spectrum of donor-site defcits following harvest of this fap has been reported. Compromised healing of the radial donor site is a signifcant cause of postoperative morbid- ity. Tendon exposure and adhesion formation cause delayed healing, poor cosmesis, and loss of function [3, 4]. Several surgical techniques have been proposed to improve skin graft take and tendon exposure and subsequent undesirable results at donor site. * Anil Kumar Desai anildes2006@yahoo.in Niranjan Kumar drniranjan108@gmail.com Vividha Singhania vividha.singhania@gmail.com K. B. Srikanth srikanthkoikude@gmail.com Avinash Prabhu avinashgp@yahoo.com 1 Department of Cranio-facial Surgery and Research Centre, S. D. M. College of Dental Science and Hospital, Dharwad 580009, India