Fibula Flap Donor Site Wound Healing with Compression Stockings

Abstract

Objective: Investigate the efficacy of graduated compression stockings (GCSs) at improving donor site skin graft take after fibula free flap (FFF). Method: Retrospective review of 12 patients (13 donor sites) that underwent FFF for mandibular reconstruction over a 1-year period. One-third of the patients were instructed to use graduated compression stockings after removal of the initial wound-vac dressing. Wound healing was followed closely for all patients. Operative and comorbid factors were reviewed. Results: Two patients reported regular GCS use and 2 were non-compliant. Both patients with regular use had excellent wound healing and 90% to 100% skin graft take. Of the remaining 11 donor sites, 3 had no wound complications, 4 had minor wound complications, 3 had major wound complications, and 1 was lost to follow-up. Skin graft area varied with an average of 25 cm2 for GCS patients and 60 cm2 for non-GCS. Cardiovascular disease, alcohol use, and smoking were more common among the non-GCS group with strong tendency toward patients with major wound complications. Other operative and comorbid factors were similar between groups. Conclusion: Graduated compression stocking use demonstrates some promise for use in fibula free flap donor site healing. Patients wearing GCSs had excellent wound healing and no morbidities related to their use. Further studies are warranted to determine if improvement in fibular donor site wound healing occurs with GCS use.