Clinical Case Series: Use of Noncontact, Low-Frequency Ultrasound Therapy (NLFUT)* to Improve Outcomes of Non-healing Surgical Sites of Patients with Radial Free Flaps with Spit-Thickness Autograft

Purpose:  Clinical case series illustrates the benefits of using NLFUT* for non-healing surgical sites of radial forearm free flaps secondary to a neck resection approach.

Problem:   Three patients presented with non-healing radial forearm free flap surgical sites.  Patient A had bilateral select neck dissection with radial forearm free flap to repair glossectomy defect.  Patient B had right subtotal temporal bone resection with neck resection approach with left radial forearm free flap.  Patient C had mandibulectomy, left neck dissection radial forearm free flap.

 Past Management:  Patient A was treated with silver calcium alginate+.  Patient B was treated with silver calcium alginate+.  Patient C was treated with silver fabric dressing±.

Current Approach:  Patient A was treated with NLFUT* and Methyllin Blue Crystal Violet**.  Patient B was treated with NLFUT* and calcium alginate Ag+.  Patient C was treated with NLFUT* and with silver fabric dressing±.

Outcome:   

Patient A:  NLFUT* facilitated the removal of non-viable graft and promoted epithelialization of the fragile graft.  Graft color improved and granulation growth over tendon was facilitated. 

Patient B:  NLFUT* facilitated the removal of non-viable graft and promoted epithelialization.  Improvement noted in the color of graft.

Patient C:  NLFUT* facilitated removal of biofilm and growth of granulation tissue over exposed tendon.  Experienced total volume reduction of 83.3% in 3 weeks.

Conclusion:  Noncontact, Low-Frequency Ultrasound Therapy (NLFUT)* is beneficial for the healing of non-healing surgical sites of radial forearm free flap with split –thickness autograft.

*Mist Therapy

+Maxorb Ag

±Silverlon

**Hydrofera Blue